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A MIND THAT FOUND ITSELF

AUTHOR'S NOTE

TO

REVISED, FOURTH EDITION

The attention of those who may
have read an earlier edition of this
book is invited to important addi¬
tions in this revised, Fourth Edition,
published in March, 1917. New
material is presented on pages 243 to
246, and in Part V, pages 3 19 to 407.
This concluding chapter (PartV)
contains letters from eminent Amer¬
icans who helped make possible the
accomplishment of many ot the
plans presented in the first edition
of the book. The nature and value
of the work that has been done is
also described in Part V.

C.W. B.

A MIND THAT
FOUND ITSELF

AN AUTOBIOGRAPHY

BY

CLIFFORD WHITTINGHAM BEERS

FOURTH EDITION

LONGMANS, GREEN AND CO.

FOURTH AVENUE & 30™ STREET, NEW YORK
39 PATERNOSTER ROW, LONDON
BOMBAY, CALCUTTA, AND MADRAS
1917

COPYRIGHT, 1907 AND 1917, BY
CLIFFORD WHITTINGHAM BEERS

All Rights Reserved

First edition, March, igoS
Second edition, with additions, June, igio
Reprinted, November, igi2
Third edition revised, March, igi3
Reprinted, September, igi3
Reprinted, July, igi4
Fourth edition revised, March, igi7

IDeSicateU

TO THE MEMORY OF MY UNCLE

SAMUEL EDWIN MERWIN

WHOSE TIMELY GENEROSITY I BELIEVE SAVED MY LIFE,
AND WHOSE DEATH HAS FOREVER ROBBED
ME OF A SATISFYING OPPORTUNITY
TO PROVE MY GRATITUDE

INTRODUCTION

A story so strange as to challenge belief must needs be
presented in a way especially calculated to inspire con¬
fidence. Thanks to the late Professor William James of
Harvard University, one of the most eminent of American
psychologists, I am able to cut off incredulity at its source
by quoting his opinion.

95 Irving St., Cambridge, Mass.

July i, 1906.

Dear Mr. Beers:

Having at last “got round” to your MS., I have read it with very
great interest and admiration for both its style and its temper. I
hope you will finish it and publish it. It is the best written out
“case” that I have seen; and you no doubt have put your finger on
the weak spots of our treatment of the insane, and suggested the right
line of remedy. I have long thought that if I were a millionaire, with
money to leave for public purposes, I should endow “Insanity”
exclusively.

You were doubtless a pretty intolerable character when the maniacal
condition came on and you were bossing the universe. Not only
ordinary “tact,” but a genius for diplomacy, must have been needed
for avoiding rows with you; but you certainly were wrongly treated

nevertheless; and the spiteful Assistant M.D. at - deserves to

have his name published. Your report is full of instructiveness for
doctors and attendants alike.

The most striking thing in it to my mind is the sudden conversion of
you from a delusional subject to a maniacal one — how the whole delu¬
sional system disintegrated the moment one pin was drawn out by
your proving your brother to be genuine. I never heard of so rapid
a change in a mental system.

vii

VJ1I

INTRODUCTION

You speak of re-writing. Don’t you do it. You can hardly
improve your book. I shall keep the MS. a week longer as I wish to
impart it to a friend.

Sincerely yours,

Wm. James.

95 Irving St., Cambridge, Mass.
November io, 1907.

Dear Mr. Beers:

You are welcome to use the letter I wrote to you (on July 1,
1906) after reading the first part of your MS. in any way your judg¬
ment prompts, whether as preface, advertisement, or anything else.
Reading the rest of it only heightens its importance in my eyes. In
style, in temper, in good taste, it is irreproachable. As for contents,
it is fit to remain in literature as a classic account “from within”
of an insane person’s psychology.

The book ought to go far toward helping along that terribly needed
reform, the amelioration of the lot of the insane of our country, for
the Auxiliary Society which you propose is feasible (as numerous
examples in other fields show), and ought to work important effects
on the whole situation.

You have handled a difficult theme with great skill, and produced
a narrative of absorbing interest to scientist as well as layman. It
reads like fiction, but it is not fiction; and this I state emphatically,
knowing how prone the uninitiated are to doubt the truthfulness of
descriptions of abnormal mental processes.

With best wishes for the success of the book and the plan, both of
which, I hope, will prove epoch-making, I remain,

Sincerely yours,

Wm. James.

Clifford W. Beers, Esq.

CONTENTS

PART I

PAGE

Chapters I-XXV

PART II

•

I

Ch.apters XXVI-XXXI

PART III

•

•

•

212

Ch.apters XXXII-XXXV

PART IV

•

•

256

Chapters XXXVI-XXXIX

PART V

•

°

29I

Chapter XL

Appendices

• • •

•

•

•

319

IX

THIS BOOK IS WRITTEN BY ONE WHOSE RARE
EXPERIENCES IMPEL HIM TO PLEAD FOR
THOSE AFFLICTED THOUSANDS
LEAST ABLE TO SPEAK
FOR THEMSELVES

A Mind That Found Itself

part I

I

This story is derived from as human a document as ever
existed; and, because of its uncommon nature, perhaps no
one thing contributes so much to its value as its authenticity.
It is an autobiography, and more: in part it is a biography;
for, in telling the story of my life, I must relate the history of
another self — a self which was dominant from my twenty-
fourth to my twenty-sixth year. During that period I was
unlike what I had been, or what I have been since. The
biographical part of my autobiography might be called the
history of a mental civil war, which I fought single-handed
on a battle-field that lay within the compass of my skull.
An Army of Unreason, composed of the cunning and treach¬
erous thoughts of an unfair foe, attacked my bewildered
consciousness with cruel persistency, and would have de¬
stroyed me, had not a triumphant Reason finally interposed
a superior strategy that saved me from my unnatural self.

I am not telling the story of my life just to write a book.
I tell it because it seems my plain duty to do so. A marvel¬
ous escape from death and a miraculous return to health
after an apparently fatal illness are enough to make a man
ask himself: For what purpose was my life spared? That
question I have asked myself, and this book is, in part, an
2

I

2 A MIND THAT FOUND ITSELF

answer. Until some one tells just such a story as mine and
tells it sanely, needless abuse of helpless thousands will con¬
tinue. Great advances toward the intelligent and humane
treatment of the insane have no doubt been made ad¬
vances so great that the majority of insane patients in this
country are now treated with a consideration which amounts
to kindness. But a helpless and irresponsible minority ,
numbering thousands, are still being subjected to abuse as
brutal as any ever visited on insane persons during those
centuries when the strong took pleasure in torturing the

weak.

That insane persons are still abused is suspected by the
public at large; but direct and convincing proof of that fact
is seldom presented. I am sure that the proof I now
offer will ring true, and will contribute to the correction of
many mistaken ideas regarding the insane and their treat¬
ment, and regarding insanity itself. In the discussion of
the crude methods of treatment which now obtain, all abuses
which fell under my observation will of necessity be laid bare.
A former victim of these methods, I feel at liberty to attack
them; and the right to do so is doubly mine as I have a rem¬
edy to offer, or at least a campaign to propose. If intelli¬
gently carried on, it will, I feel confident, largely atone for
one of the blackest pages in history. As the hostages which
Civilization gives to Progress, the insane are entitled to the
best of treatment. Certainly they are not deserving of the

worst.

The subject which I treat is not alone humanitarian.
Its economic importance can hardly be overestimated.
The ravages of insanity cost millions of dollars and thou¬
sands of lives each year. According to the federal census
of January i, 1910, there were at that time 187,791 persons
in institutions for the insane in this country. This number

A MIND THAT FOUND ITSELF

3

exceeded the combined enlisted strength of the United
States Army, Navy and Marine Corps, as given in that
census, and also the number of students who were then
enrolled in all of our colleges and universities. As it is
known that the population of our public institutions for
the insane has increased at the rate of at least five thou¬
sand a year since the census of 1910, it is safe to say that
there are now (1917) about a quarter of a million persons
in such institutions in this country. Had all States pro¬
vided as adequately for their insane as do New York and
Massachusetts, there would now be more than 300,000
patients in public hospitals for the insane. This estimate
is based on the fact that the “ratio of insanity” to the
general population is known to be virtually the same in
all States. That which varies is not the “ratio” but the
adequacy of hospital accommodations provided.

The cost of caring for the insane and the economic loss
sustained through the withdrawal from productive labor
of the thousands of persons who become insane in the
prime of life — during which period the majority of cases
develop — is a great drain on the resources of the nation.
The total amount expended annually by the several States
for the care of the insane is in excess of $35,000,000. In
the year 1911, the amount appropriated by the State of
New York for the maintenance of its hospitals for the
insane was twenty-three per cent of its total expenditures,
the only item of expense that exceeded it being the legis¬
lative appropriation for public education.

Despite the gravity of these conditions, comparatively
little has been done to diminish the burden placed upon
the public by mental diseases. For generations it has been
the practice of the several States to provide only for devel¬
oped cases of mental disorder and even this has too often

4 A MIND THAT FOUND ITSELF

been done tardily and unintelligently. The outlook, how¬
ever, is encouraging. Many States are now making effective
efforts to improve their system of care and a few have even
begun to do preventive work. Best of all, the general
public is beginning to learn that many forms of mental
disorder are both recoverable and preventable. Even with
the prevailing standards of care and treatment, about
twenty per cent of those placed in institutions recover
and an added twenty per cent recover sufficiently to
warrant their being discharged as “improved.” When all
patients committed receive prompt and scientific treat¬
ment, these percentages will, no doubt, be increased.

In presenting this book I have several definite purposes.
First: I hope to rob insanity of many of its terrors at
least those which do not rightly belong to it. Most chil¬
dren are afraid of the dark until they learn that its hidden
monsters are imaginary. But this childish fear is a sublime
mental process compared with the unreasoning dread of
insanity that prevails in the minds of most adults through¬
out the civilized world. Under certain conditions an insane
person is, without doubt, the unhappiest of men, but I
shall prove that sometimes he is not less happy is indeed
happier — than a sane person under the most favorable
conditions. To a startling degree the unhappiness of the
insane is directly due to the perhaps unconscious lack
of consideration with which they are treated. This is
fortunate; for these external contributory causes can be
eliminated; — and no one thing will go so far toward elim¬
inating them as the universal adoption and continued
use of the humane and equally scientific principle of Non-
Restraint in the treatment of mental disorders. As the
reader will come to know: — doing to the insane as tire
sane would be done by is the essence of Non-Restraint.

A MIND THAT FOUND ITSELF 5

Secondly: Books alone can never produce the desired
results. But a society founded and endowed for the sole
purpose of solving this stubborn problem can at least
raise the standard of treatment to such a level that existing
shortcomings will be forever done away with. A campaign
of education carried out under the auspices of a National
Society should lead not only to effectual reform, but help
also in the important work of conserving the mental health
of the nation by preventing the occurrence of many cases
of mental disorder known to be preventable. There are
several kinds of preventive work that may be done with
hope of success, but none is so likely to produce lasting
results as that which has for its object the discovery^
treatment and continued guidance of children of nervous
or psychopathic tendencies, of whom there are thousands.
To aid those persons — both children and adults — who
are unable so to adjust themselves to their environment as
to lead efficient and happy lives is the highest aim of mental
hygiene.

Thirdly: It is my hope that the beneficent rich may be
prompted to come to the aid of the States and Nation by
supplying funds for the erection and endowment of model
institutions wherein mental and nervous diseases, in their
incipient and curable stages, may be treated with the
maximum efficiency. With such institutions — hospitals
and sanatoriums — in operation, thousands of those who
now are committed indiscriminately could be restored to
ealth and society without having suffered the unfair
stigma of legal incompetence.

Since the first edition of this book was published in
1908, several of the purposes mentioned on the preceding

6

A MIND THAT FOUND ITSELF

pages have been accomplished. In trying to help the
insane, I builded better than I knew. My story, supple¬
mented by efforts of my own and by generous help from
many representative men and women whose interest I
enlisted, served to focus forces which are now helping also
the mentally deficient or feeble-minded, the epileptic,
the inebriate, in fact all of the mentally abnormal
groups. An intimate account of the origin of what is now
known as the mental hygiene movement and a description
of the development of the work will be found in PartV,
beginning on page 319 of this revised edition of my
autobiography.

II

I was born shortly after sunset about thirty years ago.
My ancestors, natives of England, settled in this country not
long after the Mayflower first sailed into Plymouth Harbor.
And the blood of these ancestors, by time and the happy
union of a northern man and a southern woman — my
parents — has perforce been blended into blood truly Amer¬
ican.

The first years of my life were not unlike those of thousands
of other American boys. Nothing out of the ordinary
occurred. At the usual age, I entered a public Grammar
School in New Haven, Connecticut, and was graduated in
1891. In the fall of that year I entered the Hillhouse High
School of the same city. My school courses were completed
with as little trouble as scholastic distinction. I always man¬
aged to gain promotion, however, when it was due; and,
though few of my teachers credited me with real ability, they
were always able to detect a certain latent capacity, which
they evidently believed would one day develop sufficiently
to prevent me from disgracing them.

Upon entering the High School I had such ambitions as
any schoolboy is apt to have. I wished to secure an election
to a certain secret society; that gained, I wished to become
business manager of a monthly magazine, published by that
society. In these ambitions I succeeded. For one of my
age I had more than an average love of business. Indeed,
I deliberately set about learning to play the guitar well
enough to become eligible for membership in the Banjo-

7

8

A MIND THAT FOUND ITSELF

Club — and this for no more aesthetic purpose than to
place myself in line for the position of manager.

In athletics there was but one game, tennis, in which I was
actively interested. Its quick give-and-take suited my tem¬
perament, and so fond was I of it that during one summer I
played not fewer than four thousand games. As I had an
aptitude for tennis, and devoted more time to it than did any
of my schoolmates, it was not surprising that I acquired skill
enough to win the school championship during my senior
year. But that success was not due entirely to my superior¬
ity as a player. It was due in part to what I considered un¬
fair treatment; and the fact well illustrates a certain trait of
character which has often stood me in good stead. Among
the spectators at the final match of the tournament w ere
several girls. These schoolmates, who lived in m) neigh¬
borhood, had mistaken for snobbishness a certain boyish
diffidence for which few people gave me credit. When we
passed each other, almost daily, this group of girls and I,
our mutual sign of recognition was a look in an opposite
direction. Now my opponent was well liked by these same
girls and was entitled to their support. Accordingly they
applauded his good plays, which was fair. They did not
applaud my good plays, which was also fair. But what \\ as
not fair was that they should applaud my bad plays. Their
doing so roiled iny blood, and thanks to those who would
have had me lose, I won.

One more incident of my boyhood days may assist the
reader to make my acquaintance. In my early teens I was,
for one year, a member of a boy-choir. Barring my voice,
I was a good chorister, and, like all good choir-boys, I was
distinguished by that seraphic passiveness from which a
reaction of some kind is to be expected immediately after a
service or rehearsal. On one occasion this reaction in me

A MIND THAT FOUND ITSELF

9

manifested itself in a fist fight with a fellow choir boy.
Though I cannot recall the time when I have not relished
verbal encounters, physical encounters had never been to
my taste, and I did not seek this fight. My assailant really
goaded me into it. If the honors were not mine, at least I
must have acquitted myself creditably, for an interested
passer-by made a remark which I have never forgotten:
“That boy is all right after he gets started,” said he. About
twelve years later I did get started, and could that passer-by
have seen me on any one of several occasions, he would have
had the satisfaction of knowing that his was a prophetic eye.

In June, 1894, I received a High School diploma. Shortly
afterwards I took my examinations for Yale, and the follow¬
ing September entered the Sheffield Scientific School.

The last week of June, 1894, was an important one in my
life. An event then occurred which undoubtedly changed
my career completely. It was the direct cause of my mental
collapse six years later, and of the distressing and, in some
instances, strange and delightful experiences on which this
book is based. The event was the illness of an older
brother, who, late in June, 1894, was stricken with what
was thought to be epilepsy. Few diseases can so disorgan¬
ize a household and distress its members. My brother had
enjoyed perfect health up to the time he was stricken; and,
as there had never been a suggestion of epilepsy, or any
like disease, in either branch of the family, the affliction
came as a bolt from a clear sky. Everything possible
was done to effect a cure, but without avail. On July
4th, 1900, he died at the City Hospital, in Hartford,
Connecticut, after a six years’ illness, two years of which
were spent at home, one year in a trip around the
world in a sailing vessel, and most of the remainder on a
farm near Hartford. The doctors decided that a tumor at

IO

A MIND THAT FOUND ITSELF

the base of the brain had caused his malady and his death.
That tumor was caused probably by a fall which he had
suffered some years before, and to which no attention had
been paid at the time.

As I was in college when my brother was first stricken I
had more time at my disposal than the other members of
the family, and for that reason spent much of it with him.
Though his attacks during the first year occurred only at
night, it was the fear that they might occur during the day, in
public, which affected my nerves from the beginning.

Now, if a brother who had enjoyed perfect health all his
life could be stricken with epilepsy, what was to prevent my
being similarly afflicted ? d his was the thought that soon
got possession of my mind. The more I considered it and
him, the more nervous I became; and the more nervous, the
more convinced that my own breakdown was only a ques¬
tion of time. Doomed to what I then considered a living
death, I thought of epilepsy, I dreamed epilepsy, until thou¬
sands of times during the six years that this disquieting idea
persisted, my overwrought imagination seemed to drag me
to the very verge of an attack. Yet at no time during my
life have these early fears been realized.

For the fourteen months succeeding the time my brother
was first stricken, I was greatly harassed with fear, but not
until later did my nerves really conquer me. I remember
distinctly when the break came. It happened in Novem¬
ber, 1895, during a recitation in German. That hour in the
class-room was one of the most disagreeable I ever experi¬
enced. It seemed as if my nerves had snapped, like so many
minute bands of rubber stretched beyond their elastic limit.
At this time, and on many subsequent like occasions, the
one thought uppermost in my mind, though I gave no out¬
ward evidence of my great despair, was that my psychic

A MIND THAT FOUND ITSELF

II

convulsion would become physical. My imagination seemed
to tear my body into shreds. Had I had the courage to
leave the room, I should have done so; but I sat as if para¬
lyzed until the class was dismissed.

That term I did not again attend recitations. Continuing
my studies at home I passed satisfactory examinations which
enabled me to resume my place in the class-room the follow¬
ing January. During the remainder of my college years I
seldom entered a recitation-room with any other feeling than
that of dread, though the absolute assurance that I should
not be called upon to recite did mitigate the misery. The
professors, who had been told about my state of health and
the cause of it, invariably treated me with consideration;
but, though I believe they never doubted the genuineness
of my excuse, it was no easy matter to keep them convinced
for almost two of the three years of my course. My inability
to recite was not due usually to any lack of preparation.
However well prepared I might be, the moment a professor
called upon me to recite, a mingling of a thousand disconcert¬
ing sensations, and the distinct thought that at last the dread
attack was at hand, would suddenly intervene and deprive
me of all but the power to say, “Not prepared.” Weeks
would pass without any other record being placed opposite
my name than a zero, or a blank indicating that I had not
been called upon at all. Occasionally, however, a profes¬
sor, in justice to himself and to the other students, would
compel me to recite, and at such times I managed to make
enough of a recitation to hold my place in the class.

WTien I entered Yale I had four definite ambitions: first,
to secure an election to a certain secret society; second, to
become one of the editors of the Yale Record, an illus¬
trated humorous bi-weekly; third (granting that 1 should
have succeeded in this latter ambition), to convince my col-

12

A MIND THAT FOUND ITSELF

leagues that I should have the position of business-mana¬
ger — an office which I sought, not for the honor, but be¬
cause I believed it would enable me to earn an amount of
money at least equal to the cost of tuition for my three years
at Yale; fourth (and this was my chief ambition), to win
my diploma within the prescribed time. These four ambi¬
tions I fortunately achieved.

A man’s college days, collectively, are usually his happi¬
est. Most of mine were not happy. Yet I look back upon
them with great satisfaction, for I feel that I was fortunate
enough to absorb some of that intangible but very real ele¬
ment known as the “Yale spirit.” This has helped to keep
Hope alive within me during my most discouraged moments,
and now makes the accomplishment of my purpose seem
easy and sure.

Ill

On the thirtieth day of June, 1897, I was graduated at
Yale. Had I then realized that I was a sick man I could and
would have taken a rest; but, in a way, I had become ac¬
customed to the ups and downs of a nervous existence, and,
as I could not really afford a rest, six days after my gradua¬
tion I entered upon the duties of a clerk in the office of the
Collector of Taxes in the city of New Haven. I was fortunate
in securing such a position at that time, for the hours were
comparatively short and the work as congenial as any could
have been under the circumstances. I entered the Tax Office
with the intention of staying only until such time as I should
secure a position in New York. About a year later I secured
the desired position. After remaining in it for eight months
(with the firm whose employ I re-entered in 1904), I left it,
in order to take a position which seemed to offer a field of
endeavor more to my taste. From May, 1899, till the middle
of June, 1900, I was a clerk in one of the smaller life insur¬
ance companies, whose home office was within a stone’s
throw of what some men consider the center of the universe.
To be in the very heart of the financial district of New
York appealed strongly to my imagination. As a result of
certain mistaken ideals, the making of money was then a
passion with me. I foolishly wished to taste the bitter-sweet
of power based on wealth.

For the first eighteen months of my life in New York, my
health seemed no worse than it had been during the preceding
three years. The old dread still possessed me. I continued

13

i4 A MIND THAT FOUND ITSELF

to have my more and less nervous days, weeks, and months.
In March, 1900, however, there came a change for the worse.
At that time I had a severe attack of grip which incapaci¬
tated me for two weeks. As was to be expected in my case,
this illness seriously depleted my vitality, and left me
in a frightfully depressed condition — a depression which
continued to grow upon me until the final crash came, on
June 23d, 1900. The events of that day, seemingly disas¬
trous as then viewed, but all for the best as the issue proved,
forced me along paths traveled by thousands, but compre¬
hended by few.

I had continued to perform my clerical duties until June
15th. On that day I was compelled to stop, and that at
once. I had reached a point where my will had to capitu¬
late to Unreason — that unscrupulous usurper. My pre¬
vious five years as a neurasthenic had led me to believe that
I had experienced all the disagreeable sensations an over¬
worked and unstrung nervous system could suffer. But on
this day several new and terrifying sensations seized me and
rendered me all but helpless. My condition, however, was
not apparent even to those who worked with me at the same
desk. I remember trying to speak and at times finding my¬
self unable to give utterance to my thoughts. Though I was
able to answer questions, that fact hardly diminished my
feeling of apprehension, for a single failure in an attempt to
speak will stagger any man, no matter what his state of
health. I tried to copy certain records in the day s work,
but my hand was too unsteady, and I found it difficult to
read the words and figures presented to my tired vision in
blurred confusion.

That afternoon, conscious that some terrible calamity was
impending, but not knowing what would be its nature, I
performed a very curious act. Certain early literary efforts

A MIND THAT FOUND ITSELF

15

which had failed of publication in the college paper, but
which I had jealously cherished for several years, I utterly
destroyed. Then, after a hurried arrangement of my affairs,
I took an early afternoon train, and soon found myself at
home. Home life did not make me better, and, except for
three or four short walks, I did not go out of the house at all
until June 23d, when I went in a most unusual way. To
relatives I said little about my state of health, beyond the
general statement that I had never felt worse — a statement
which, when made by a neurasthenic, means much but proves
little. For five years I had had my ups and downs, and
both my relatives and myself had begun to look upon these
as things which would probably be corrected in and by time.
Had the seriousness of my condition been realized, earlier
arrangements would have been made which would have
enabled me to take the long rest I needed. I am now glad
that no such rest was taken. Had I been restored to health
sooner than I was, or under different conditions, I should
not have suffered and learned; nor should I have tasted the
peculiar joy of a life little known and less understood by
mankind at large.

The day after my home-coming I made up my mind, or
that part of it which was still within my control, that the
time had come to quit business entirely and take a rest of
months. I even arranged with a younger brother to set out
at once for some quiet place in the White Mountains, where
I hoped to steady my shattered nerves. At this time (to
say nothing of the constantly recurring thought that I was
about to fall into an epileptic attack) I felt as though in a
tremor from head to foot.

This dread to which I so frequently refer was a thing which
I seldom, if ever, referred to while it persisted. On more
than one occasion I did say to my friends that I would rather

16 A MIND THAT FOUND ITSELF

die than live an epileptic; yet, if I rightly remember, I never
declared the actual fear that I was doomed to bear such an
affliction. However, I believe that I said on a few occasions,
though without meaning it at the time, that, if necessary, I
should kill myself rather than endure what I then thought,
but do not now think, the most miserable of lives. Though
I held the mad belief that I should suffer epilepsy, I held the
sane hope, amounting to belief, that I should escape it.
This fact may account, in a measure, for my six years of
endurance.

On the 1 8th of June I felt so much worse that I went
to my bed and stayed there until the 23d. During the night
of the 1 8th my persistent dread became a false belief
— a delusion. What I had long expected I now became
convinced had at last occurred. I believed myself to be a
confirmed epileptic, and that conviction was stronger than
any ever held by a sound intellect. The half-resolve, made
before my mind was actually impaired, namely, that I would
kill myself rather than live the life I dreaded, now divided
my attention with the belief that the stroke had fallen. From
that time my one thought was to hasten the end, for I felt
that I should lose the chance to die should relatives find
me in a seizure of the supposed malady.

Considering the state of my mind and my inability at that
time to appreciate the enormity of such an end as I half con¬
templated, my suicidal purpose was not entirely selfish. That
I had never seriously contemplated suicide is proved by the
fact that I had not provided myself with the means of accom¬
plishing it, despite my habit, which has long been remarked
by those intimately acquainted with me, of preparing for
unlikely contingencies. So far as I had the control of my
faculties, it must be admitted that I deliberated; but, strictly
speaking, the rash act which followed cannot correctly be

A MIND THAT FOUND ITSELF

17

called an attempt at suicide — for, how can a man who is
not himself kill himself?

Soon my disordered brain was busy with schemes for
death. I distinctly remember one which included a row on
Lake Whitney, near New Haven. This row I intended to
take in the most treacherous boat obtainable. Such a craft
could be easily upset, and I should so bequeath to relatives
and friends a sufficient number of reasonable doubts to rob
my death of the usual stigma. I also remember searching
for some deadly drug which I hoped to find about the house.
But the quantity and quality of what I found was not such
as I dared to trust. I then thought of severing my jugular
vein, even going so far as to test against my throat the edge
of a razor which, after the deadly impulse first asserted itself,
I had secreted in a convenient place. I really wished to die,
but so uncertain and bloody a method did not appeal to me.
Nevertheless, had I felt sure that in my tremulous frenzy I
could accomplish the act with skilful dispatch, I should
at once have ended my troubles.

My imaginary attacks were now recurring with distracting
frequency, and I was in constant fear of discovery. During
these three or four days I slept scarcely at all — even the
medicine given to induce sleep having little effect. Though
inwardly frenzied, I gave no outward sign of my condition.
Most of the time I remained quietly in bed. I spoke but
seldom. I had practically, though not entirely, lost the power
of speech; and my almost unbroken silence aroused no sus¬
picions as to the seriousness of my plight.

By a process of elimination, all suicidal methods but one
had at last been put aside. On that one my mind now cen¬
tered. My room was on the fourth floor of a house — one
of a block of five — in which my parents lived. The house
stood several feet back from the street. The sills of my win-

18 A MIND THAT FOUND ITSELF

dows were a little more than thirty feet above the ground.
Under one was a flag pavement, extending from the house
to the front gate. Under the other was a rectangular coal¬
hole covered with an iron grating. This was surrounded by
flagging over a foot in width; and, connecting it and the
pavement proper, was another flag. So that all along
the front of the house, stone or iron filled a space at no point
less than two feet in width. It required no great amount of
calculation to determine how slight the chance of surviving
a fall from either of these windows.

About dawn I arose. Stealthily I approached the window,
pushed open the blinds and looked out — and down. Then I
closed the blinds as noiselessly as possible and crept back to
bed : I had not yet become so desperate that I dared to take
the leap. Scarcely had I pulled up the covering when a
watchful relative entered my room, drawn thither perhaps
by that protecting prescience which love inspires. I thought
her words revealed a suspicion that she had heard me at the
window, and speechless as I was I had enough speech to
deceive her. For, of what account are Truth and Love when
Life itself has ceased to seem desirable?

The dawn soon hid itself in the brilliancy of a perfect June
day. Never had I seen a brighter — to look at ; never a
darker — to live through, — or a better to die upon. Its
very perfection and the songs of the robins, which at that
season were plentiful in the neighborhood, served but to
increase my despair and make me the more willing to die.
As the day wore on my anguish became more intense, but
I managed to mislead those about me by uttering a word
now and then, and feigning to read a newspaper, which to
me, however, appeared an unintelligible confusion of type.
My brain was in a ferment. It felt as if pricked by a million
needles at white heat. My whole body felt as though it

A MIND THAT FOUND ITSELF

19

would be torn apart by the terrific nervous strain under
which I labored.

Shortly after noon, dinner having been served, my mother
entered the room and asked me if she should bring me some
dessert. I assented. It was not that I cared for the dessert;
I had no appetite. I wished to get her out of the room, for
I believed myself to be on the verge of another attack. She
left at once. I knew that in two or three minutes she would
return. The crisis seemed at hand. It was now or never
for liberation. She had probably descended one of three
flights of stairs when, with the mad desire to dash my brains
out on the pavement below, I rushed to that window which
was directly over the flag walk. Providence must have
guided my movements, for in some otherwise unaccountable
way, on the very point of hurling myself out bodily, I chose
to drop feet foremost instead. With my fingers I clung for a
moment to the sill. Then I let go. In falling my body
turned so as to bring my right side toward the building. I
struck the ground a little more than two feet from the foun¬
dation of the house, and at least three to the left of the point
from which I started. Missing the stone pavement by not
more than three or four inches, I struck on compara¬
tively soft earth. My position must have been almost
upright, for both heels struck the ground squarely. The
concussion slightly crushed one heel bone and broke most
of the small bones in the arch of each foot, but there
was no mutilation of the flesh. As my feet struck the ground
my right hand struck hard against the front of the house,
and it is probable that these three points of contact divided
the force of the shock and prevented my back from being
broken. As it was, it narrowly escaped a fracture and, for
several weeks afterward, it felt as if powdered glass had
been substituted for cartilage between the vertebra;.

20

A MIND THAT FOUND ITSELF

I did not lose consciousness even for a second, and the
demoniacal dread, which had possessed me from June,
1894, until this fall to earth just six years later, was dispelled
the instant I struck the ground. At no time since that in¬
stant have I experienced one of my imaginary attacks,, nor
has my mind even for a moment entertained such an idea.
The little demon which had tortured me relentlessly for six
years evidently lacked the stamina which I must have had to
survive the shock of my suddenly arrested flight through
space. That the very delusion which drove me to a death-
loving desperation should so suddenly vanish, seems to me
to indicate that many a suicide might be averted if the per¬
son contemplating it could find the proper assistance when
such a crisis impends.

IV

Though I was unquestionably insane before the physical
injuries which I sustained, I am inclined to believe that
without the injuries my insanity would have manifested
itself in a mild and easily curable form. As it was, the
mere shock to my spine affected my brain and complicated
my case. Within a few hours after my fall my brain was
in a seriously disordered condition.

It was squarely in front of the dining-room window that
I fell, and those at dinner were more startled than I. It
took them a second or two to realize what had happened.
Then my younger brother rushed out, and with other assist¬
ance carried me into the house. Naturally that dinner was
permanently interrupted. A mattress was placed on the
floor of the dining-room and I on that, suffering intensely.
I said little, but what I said was significant. “I thought
I had epilepsy!” was my first remark; and several
times I said, “I wish it was over!” For I believed that my
death was only a question of hours. To the doctors, who
soon arrived, I said, “My back is broken!” — raising my¬
self slightly, however, as I said so.

An ambulance soon arrived, in which I was placed. Be¬
cause of the nature of my injuries it was necessary that the
ambulance proceed slowly. The trip of a mile and a half
seemed interminable, but in due time I arrived at Grace
Hospital and was placed in a room which soon became a
chamber of torture. It was on the second floor; and the

21

22

A MIND THAT FOUND ITSELF

first object to engage my attention and stir my imagination
was a man who appeared outside my window and placed in
position several heavy iron bars. These were, of course,
for my protection, but at that time no such idea occurred to
me. My mind was in a delusional state, ready and eager
to adopt any external stimulus as a pretext for its wild in¬
ventions, and that barred window started a terrible train of
delusions which persisted for seven hundred and ninety-eight
days. During that period my mind imprisoned both mind
and body in a dungeon than which none was ever more secure.

Knowing that those who attempt suicide are usually placed
under arrest, I believed myself under legal restraint. I im¬
agined that at any moment I might be taken to court to face
some charge lodged against me by the local police. Every
act of those about me seemed to be a part of what, in police
parlance, is commonly called, the “Third Degree.” The
hot poultices placed upon my feet and ankles threw me into
a profuse perspiration, and my very active association of
mad ideas convinced me that I was being “sweated” —
another police term which I had often seen in the newspapers.
I inferred that this third-degree sweating process was being
inflicted in order to extort some kind of a confession, though
what my captors wished me to confess I could not for my life
imagine. As I was really in a state of delirium, with high
fever, I had an insatiable thirst. The only liquids given me
were hot saline solutions. Though there was good reason
for administering these, I believed they were designed for no
other purpose than to increase my sufferings, as a part of the
same inquisitorial process. But had a confession been due
I could hardly have made it, for that part of my brain which
controls the power of speech was seriously affected, and was
soon to be further disabled by my ungovernable thoughts.
Only an occasional word did 1 utter.

A MIND THAT FOUND ITSELF

23

Certain hallucinations of hearing, or “false voices,” added
to my torture. Within my range of hearing, but beyond
the reach of my understanding, there was a hellish vocal hum.
Now and then I would recognize the subdued voice of a
former friend; now and then I would hear the voices of some
who I believed were not friends. All these referred to me
and uttered what I could not clearly distinguish, but knew
must be imprecations. Ghostly rappings on the walls and
ceiling of my room punctuated unintelligible mumblings of
invisible persecutors. Those were long nights.

I remember distinctly my delusion of the following day
Sunday. I seemed to be no longer in the hospital. In some
mysterious way I had been spirited aboard a huge ocean
steamship. I first discovered this when the ship was in mid¬
ocean. The day was clear, the sea apparently calm, but
for all that, the ship was slowly sinking. And it was I, of
course, who had brought on what must turn out fatally for
all, unless the coast of Europe could be reached before the
water in the hold should extinguish the fires. How had this
peril overtaken us? Simply enough: During the night I
had in some way — a way still unknown to me — opened a
port-hole below the water-line; and those in charge of the
vessel seemed powerless to close it. Every now and
then I could hear parts of the vessel give way under the
strain. I could hear the air hiss and whistle spitefully under
the resistless impact of the invading waters; I could hear the
crashing of timbers as partitions were wrecked; and as
the water rushed in at one place I could see, at another,
scores of helpless passengers swept overboard into the sea —
my unintended victims. I believed that I too might at any
moment be swept away. That I was not thrown into the
sea by vengeful fellow-passengers was, I thought, due to
their desire to keep me alive until, if possible, land should

24

A MIND THAT FOUND ITSELF

be reached, when a more painful death could be inflicted
upon me.

While aboard my phantom-ship I managed in some way
to establish an electric railway system; and the trolley cars
which passed the hospital were soon running along
the deck of my ocean-liner, carrying passengers from the
places of peril in the ship’s hold to what seemed places of
comparative safety at the bow. Every time I heard a car
pass the hospital one of mine went clanging along the ship’s
deck.

This feverish day-dream is less remarkable than the ex¬
ternal stimuli which excited it. As I have since ascertained
there was, just outside my room, an elevator and near it a
speaking tube. Whenever the speaking-tube was used from
another part of the building, the summoning whistle con¬
veyed to my mind the idea of the exhaustion of air in a ship-
compartment, and the opening and shutting of the elevator
door completed the illusion of a ship fast going to pieces.
But the ship my mind was on never reached any shore, nor
did she sink. Like a mirage she vanished, and again I found
myself safe in my bed at the hospital. “Safe,” did I say?
Scarcely that, — for deliverance from one impending disaster
simply meant immediate precipitation into another.

My delirium gradually subsided, and four or five days
after the 23d the doctors were able to set my broken bones.
To my gradually increasing insanity the operation suggested
new delusions. Shortly before the adjustment of the plaster
casts, my legs, for obvious reasons, were shaved from shin
to calf. This unusual tonsorial operation I read for a sign
of degradation — associating it with what I had heard of the
treatment of murderers and with similar customs in more
barbarous lands. It was about this time also that strips of
court-plaster, in the form of a cross, were placed on my brow,

A MIND THAT FOUND ITSELF

25

which had been slightly scratched in my fall, and this I read
for a brand of infamy.

Had my health been good I should at this time have
been participating in the Triennial of my class at Yale. In¬
deed, I was a member of the Triennial Committee and
though, when I left New York on June 15th, I had been
feeling terribly ill, I had then hoped to brace myself for the
anticipated pleasures of the reunion. The class reunions
were held on Tuesday, June 26th — three days after my
collapse. Those familiar with Yale customs know that
the Harvard baseball game is one of the chief events of
the commencement season. Headed by brass bands, all the
classes whose reunions fall in the same year, march to the
Yale Athletic Field to see the game and renew their youth
— using up as much vigor in one delirious day as would in¬
sure a ripe old age if less prodigally expended. These
classes with their bands and cheering, accompanied by thou¬
sands of other vociferating enthusiasts, march through West
Chapel Street — the most direct route from the Campus to
the Field. It is upon this line of march that Grace Hospital
is situated, and I knew that on the day of the game the Yale
thousands would pass the scene of my incarceration.

I have endured so many days of the most exquisite tor¬
ture that I hesitate to distinguish among them by degrees;
each deserves its own unique place, even as a Saint s Day
on the calendar of an olden Spanish inquisitor. But, if the
palm is to be awarded to any, June 26th, 1900, perhaps has
the first claim.

My state of mind at this time might be pictured thus:
The criminal charge of attempted suicide stood against me
on June 23d. By the 26th many other and worse charges
had accumulated. The public believed me the most des¬
picable member of my race. The papers were filled with

26

A MIND THAT FOUND ITSELF

accounts of my misdeeds. The thousands of collegians gath¬
ered in the city, many of whom I knew personally, loathed
the very thought that a Yale man should so disgrace his
Alma Mater. And when they approached the hospital on
their way to the Athletic Field, I concluded that it was their
intention to take me from my bed, drag me to the lawn, and
there tear me limb from limb. Few incidents during my
unhappiest years are more vividly or circumstantially
impressed upon my memory. The fear, to be sure, was
absurd, but in the lurid lexicon of Unreason there is no such
word as “absurd.” Believing, as I did, that I had dis¬
honored Yale and forfeited the privilege of being numbered
among her sons, it was not surprising that the college cheers
which filled the air that afternoon, and in which I, only
a few days earlier, had hoped to join, struck terror to my
heart.

V

Naturally I was suspicious of all about me, and became
more so each day. But not until about a month after my
hurt did I refuse to recognize my relatives. While I was at
Grace Hospital my father and eldest brother called almost
every day to see me, and, though I said little, I still accepted
them in their proper characters. I remember well a conver¬
sation one morning with my father. The words I uttered
were few but full of meaning. Shortly before this time my
death had been momentarily expected. I still believed that
I was surely about to die as a result of my injuries, and I
wished in some way to let my father know that, despite my
apparently ignominious end, I appreciated all that he had
done for me during my life. Few men, I believe, ever had
a more painful time in expressing their feelings than I had on
that occasion. I had but little control over my mind, and
my power of speech was impaired. My father sat beside
my bed. Looking up at him, I said, “You have been a
good father to me.”

“I have always tried to be,” was his characteristic reply.

After the broken bones had been set, and the first effects
of the severe shock I had sustained had worn off, I began to
gain strength. About the third week I was able to sit up
and was occasionally taken out of doors. But each day, and
especially during the hours of the night, my delusions in¬
creased in force and variety. The world was fast becoming
to me a stage on which every human being within the range
of my senses seemed to be playing a part, and that a part

27

28

A MIND THAT FOUND ITSELF

which would lead not only to my destruction (for which I
cared little), but also to the ruin of all with whom I had ever
come in contact. In the month of July several thunder¬
storms occurred. To me the thunder was “stage” thunder,
the lightning, man-made, and the accompanying rain due
to some clever contrivance of my persecutors. There was
a chapel connected with the hospital — or at least a room
where religious services were held every Sunday. To me
the hymns were funeral dirges; and the mumbled prayers,
faintly audible, were in behalf of every sufferer in the world
but one.

It was my eldest brother who looked after my care and
interests during my entire illness. Toward the end of July,
he informed me that I was to be taken home again.
I must have given him an incredulous look, for he
said, “Don’t you think we can take you home? Well,
we can and will.” Believing myself in the hands of the
police I did not see how that was possible. Nor did I have
any desire to return. That a man who had disgraced his
family should again enter his old home, and expect his rel¬
atives to treat him as though nothing were changed, was a
thought against which my whole nature rebelled; and, when
the day came for my return, I fought my brother and the
doctor feebly as they lifted me from the bed. But, realizing
the uselessness of resistance, I soon submitted, was placed
in a carriage, and driven to the house I had left a month
earlier.

For a few hours my mind was easier than it had been.
But my new-found ease was soon dispelled by the appear¬
ance of a nurse — one of several who had attended me at the
hospital. Though at home and surrounded by relatives I

A MIND THAT FOUND ITSELF

29

jumped at the conclusion that I was still under police sur¬
veillance. At my request my brother had promised not to
engage any nurse who had been in attendance at the hos¬
pital. The difficulty of procuring any other led him to dis¬
regard my request, which at the time he held simply as a
whim. But he did not disregard it entirely, for the nurse
selected had merely acted as a substitute on one occasion, and
then only for about an hour. That was long enough, though,
for my memory to become acquainted with her image. My
brother’s mistake was grave, for the unintentional breaking
of that promise broke the only remaining thread that bound
me to the world. And it is now clear to my judgment that
the most trifling promise, direct or implied, made under such
circumstances, should, if possible, be carried out to the letter.
This question I have since discussed with alienists, all of
whom agree with me. Suspicion cannot be overcome by
being fed upon untruth itself, and suspicion is the condi¬
tion of most unbalanced minds. I am convinced that the
unhappiness of many such would be greatly decreased if,
as nearly as possible, they received at the hands of sane
persons the treatment accorded sane persons. It should
never be taken for granted that a perverted mind cannot
detect a perverted moral act. To gain the shattered confi¬
dence of suspicious insane patients, their treatment should
be consistently honest and kind. But let me in all justice
and all gratitude emphasize the fact that my brother was
not to blame for his error of judgment; and without abating
a jot of my conviction that such little subterfuges are injuri¬
ous to the patient and should be scrupulously avoided —
most of all by his relatives, and by the doctors and nurses
in charge of him — I must add that, of course, had it not
been this incident, almost any other would as surely have
precipitated the plunge to chaos of my swaying reason.

3°

A MIND THAT FOUND ITSELF

Finding myself still under surveillance, I soon jumped to
a second conclusion, namely: that this was no brother of
mine at all. He instantly appeared in the light of a sinister
double, acting as a detective. After that I refused abso¬
lutely to speak to him again, and this repudiation I extended
to all other relatives, friends, and acquaintances. If the man
I had accepted as my brother was spurious, so were all the
rest — such was my deduction. For more than two years I
was without relatives or friends, in fact, a man without a
world, except that one created by my own mind from the
chaos that reigned within it. Having lost all touch, even with
my mother and father whom I had seen, naturally God,
whom I had not seen, ceased to exist for me. Thus I was
denied the comfort which comes to so many in distress.

While I was at Grace Hospital it was my sense of hearing
which was the most disturbed. Soon after I was placed in
my room at home all of my senses became perverted. I
still heard the “false voices” — which were doubly false,
for Truth no longer existed. The tricks played upon me by
my perverted senses of taste, touch, smell, and sight were
the source of great mental anguish. None of my food had
its usual flavor. This soon led to that common delusion that
some of it contained poison — not deadly poison, for I knew
that my enemies hated me too much to allow me the boon
of death, but poison sufficient to aggravate my discomfort.
At breakfast I had cantaloupe, liberally sprinkled with salt.
The salt seemed to pucker my mouth, and I believed it to be
powdered alum. Usually, with my supper, sliced peaches
were served. Though there was sugar on the peaches, salt
would have done as well. Salt, sugar, and powdered alum
had become the same to me.

Familiar materials had acquired a different “ feel.” In the
dark, the bed sheets at times seemed like silk. As I had not

A MIND THAT FOUND ITSELF

31

been born with a golden spoon in my mouth, or other acces¬
sories of a useless luxury, I believed the detectives had pro¬
vided these silken sheets for some hostile purpose of their
own. What that purpose was I could not divine, and my
very inability to arrive at a satisfactory conclusion stimu¬
lated my brain to the assembling of disturbing thoughts in
an almost endless train. Thus does a perverted sense
grow by what it feeds on.

Imaginary breezes struck my face, gentle, but not welcome,
most of them from parts of the room where currents of air
could not possibly originate. They seemed to come from
cracks in the walls and ceiling and annoyed me exceedingly.
I thought them in some way related to that Chinese method
of torture by which water is allowed to strike the victim’s
forehead, a drop at a time, until death releases him.

The old doctrine of brimstone, Hell-fire, and damnation
is not so difficult for me to believe as it is for that type of
saint who would get to Glory easily, or, at least, substitute
for Heaven a sweet and unmerited oblivion. For does not
the Devil lurk in one’s nasal passages? Stifling fumes of
sulphur are as the crisp air of wooded glens compared to
the odor of burning human flesh and other pestilential
fumes which seemed to assail me.

My sense of sight was subjected to many weird and un¬
canny effects. Phantasmagoric visions made their visitations
throughout the night, for a time with such regularity that I
used to await their coming with a certain restrained curiosity.
Although I was not entirely unaware that something was
ailing with my mind, I did not accept these visions, or any
other abnormal effects of sense, as symptoms of insanity.
All these horrors I took for the work of detectives, who sat
up nights racking their brains in order to rack and utterly
wreck my own with a cruel and unfair “Third Degree.”

32

A MIND THAT FOUND ITSELF

Handwriting on the wall has ever struck terror to the
hearts of sane men. I remember as one of my most unpleas¬
ant experiences that I began to see handwriting on the sheets
of my bed staring me in the face, and not me alone, but
also the spurious relatives who often stood or sat near me.
On each fresh sheet placed over me I would soon begin to
see words, sentences, and signatures, all in my own hand¬
writing. Yet I could not decipher any of the words, and
this fact dismayed me, for I firmly believed that those who
stood about could read them all and found them to be
incriminating evidence.

I imagined that these vision-like effects, with few excep¬
tions, were produced by a magic-lantern, controlled by
some of my myriad persecutors. The lantern was rather a
cinematographic contrivance. Moving pictures, often bril¬
liantly colored, were thrown on the ceiling of my room and
sometimes on the sheets of my bed. Human bodies, dis¬
membered and gory, were one of the most common of these.
All this may have been due to the fact that, as a boy, I had
fed my imagination on the sensational news of the day as
presented in the public press. These papers I had been
accustomed to read thoroughly, reading first the worst news
and ending with the best — if I had time. Despite the heavy
penalty which I now paid for thus loading my mind, I be¬
lieve this unwise indulgence gave a breadth and variety to
my peculiar psychological experience which it otherwise
would have lacked. For with an insane ingenuity I managed
to connect myself with almost every crime of importance of
which I had ever read.

Dismembered human bodies were not alone my bed-fel¬
lows at this time. I remember one vision of vivid beauty.
Swarms of butterflies and large and gorgeous moths appeared
on the sheets. That sight I really enjoyed, knowing that

A MIND THAT FOUND ITSELF

33

the pretty creatures were not alive; and I wished that the
usually unkind operator would continue to minister to my
aesthetic taste by feeding it on colors so rich and so faultlessly
combined. Another pleasing vision appeared about twi¬
light several days in succession. I can trace it directly
to impressions gained in early childhood. The quaint
pictures by Kate Greenaway — little children in attrac¬
tive dress, playing in old-fashioned gardens — would float
through space just outside my windows. The pictures were
always accompanied by the gleeful shouts of real children
in the neighborhood, who, before being sent to bed by
watchful parents, devoted the last hour of the day to play.
It was their shouts that stirred my memories of childhood
and brought forth these pictures.

In my chamber of intermittent horrors and momentary
delights, uncanny occurrences were frequent. I believed
there was some one who at fall of night secreted himself
under my bed. That in itself was not peculiar, as sane per¬
sons, at one time or another, are troubled by that same
notion. But my bed-fellow — under the bed — was a
detective; and he spent most of his time during the night
pressing pieces of ice against my injured heels, to pre¬
cipitate, as I thought, my overdue confession.

The piece of ice in the pitcher of water which stood usu¬
ally on the table clinked against the pitcher’s side as its
center of gravity shifted through melting. It was many
days before I reasoned out the cause of this sound ; and until
I did I supposed it to be produced by some mechanical
device resorted to by the detectives for a purpose. Thus it
is that the most trifling occurrence assumes vast significance
to an unsound mind afflicted with certain types of delusion.

4

VI

After remaining at home for about a month, during which
time I showed no improvement mentally, though I did gain
physically, I was taken to a private sanatorium. My des¬
tination was frankly disclosed to me. But my habit of dis¬
belief had now become confirmed, and I thought myself on
the way to a trial in New York City, for some one of the
many crimes with which I stood charged.

My emotions on leaving New Haven were, I imagine,
much the same as those of a condemned and penitent crim¬
inal who looks upon the world for the last time. The day
was hot, and, as we drove to the railway station, the blinds
on most of the houses in the streets through which we passed
were seen to be closed. The reason for this was not then
apparent to me. I thought I saw an unbroken line of de¬
serted houses, and I imagined that their desertion had been
deliberately planned as a sign of displeasure on the part of
their former occupants. As citizens of New Haven I sup¬
posed them bitterly ashamed of such a despicable inhabitant
as myself. Because of the early hour, the streets were
practically deserted. This fact too I interpreted to my own
disadvantage; and, as the carriage crossed the main business
thoroughfare, I took what I believed to be my last look at
that portion of my native city.

From the carriage I was carried to the train and placed
in the smoking-car in the last seat on the right-hand side.
The back of the seat next in front was reversed so that my
legs might be placed in a comfortable position, and one of

34

A MIND THAT FOUND ITSELF

35

the boards used by card-playing travelers was placed beneath
them as a support. With a consistent degree of suspicion
I paid particular attention to a blue mark on the face of the
railroad ticket held by my custodian. I took it to be a means
of identification for use in court, but wherefore, I knew not.

That one’s memory may perform its function in the grip
of Unreason itself is proved by the fact that my memory
retains an impression, and an accurate one, of virtually
everything that befell me, except when under the influence
of an anaesthetic or in the unconscious hours of undisturbed
sleep. Important events, trifling conversations, and more
trifling thoughts of my own, are now recalled with ease
and accuracy; whereas, prior to my illness and up to
August 30th, 1902, when I again got in touch with my
own world, mine was an ordinary memory when it was
not noticeably poor. At school and in college I stood
lowest in those studies in which success depended largely
upon this faculty. Psychiatrists inform me that it is not
unusual for patients afflicted as I was to retain accurate
impressions of their experiences while ill. To laymen this
may seem almost miraculous, yet it is not so; nor is it even
remarkable. Assuming that an insane person’s memory is
capable of recording impressions at all, remembrance, for
one in the torturing grip of delusions of persecution, should
be doubly easy. This deduction is in accord with the ac¬
cepted psychological law: that the retention of an impression
in the memory depends largely upon the intensity of the im¬
pression itself, and the frequency of its repetition. Fearing
to speak lest I should incriminate myself and others, gave
to my impressions the requisite intensity, and the daily re¬
currence of the same general line of thought served to fix all
impressions in my then supersensitive memory.

36

A MIND THAT FOUND ITSELF

Shortly before seven in the morning, en route to the sana¬
torium, the train passed through a manufacturing center.
Many workmen were lounging in front of a factory, most of
them reading newspapers. I believed these papers con¬
tained an account of me and my crimes, and I thought every¬
one along the route knew who I was and what I was, and
that I was on that particular train. Few seemed to pay any
attention to me, yet this very fact looked to be a part of
some well laid plan of the detectives.

The sanatorium for which I was destined was situated in
the country, and when we reached a certain station I was
carried from the train to a carriage and driven thither. Just
as we alighted from the train I caught sight of a former col¬
lege acquaintance, whose appearance I thought was designed
to let me know that Yale, which I believed I had disgraced,
was one of the powers behind my throne of torture.

Soon after I reached my room in the sanatorium, the
supervisor entered. Drawing a table close to the bed he
placed upon it a slip of paper which he asked me to sign. I
looked upon this as a trick of the detectives to get a
specimen of my handwriting. I now know that the signing
of the slip is a legal requirement, with which every patient is
supposed to comply upon entering such an institution —
private in character - unless he has been committed by
some court. The exact wording of this “voluntary commit¬
ment” I do not now recall; but, in substance, it was an
agreement to abide by the rules of the institution — what¬
ever they were - and to submit to such restraint as might
be deemed necessary. Had I not felt the weight of the
world on my shoulders, I believe my sense of humor would
have caused me to laugh outright. For the signing of such
an agreement by one so situated was, even to my mind, a
farce. After much coaxing I was induced to go so far as to

A MIND THAT FOUND ITSELF

37

take the pen in my hand. There I hesitated. The super¬
visor apparently thought I might write with more ease if the
paper were placed on a book. And so I might, had he se¬
lected a book of a different title. One more likely to arouse
suspicions in my mind could not have been found in a
search of the Congressional Library. I had left New York
on June 15th, and it was now in the direction of that city
that my present trip had taken me. I considered this but
the first step of my return under the auspices of the Police
Department. “Called Back” was the title of the book that
stared me in the face. After refusing for a long time I
finally weakened and signed the slip; but I did not place it
on the book. To have done that would, in my mind, have
been tantamount to giving consent to extradition; and I
was in no mood to assist the detectives in their mean
work.

At what cost had I signed that commitment slip ?
To me it was the act of signing my own death-war¬
rant. And why should one in my irresponsible con¬
dition have been forced to undergo so heart-breaking an
ordeal ? If I was a mental incompetent — and I was —
why go through a senseless formality, meaningless in the
eyes of the law which declares an insane person incapable
of intelligent and binding action? Under such conditions
a patient should not be annoyed, and in some instances tor¬
tured, by being compelled to attend to the details of his own
commitment. As well ask the condemned to adjust the
noose. I am not opposed to “ voluntary commitments.”
I simply plead for their confinement to cases in which
the patient sufficiently appreciates his condition to be
able to make a choice. If he be past that condition let

3§

A MIND THAT FOUND ITSELF

the law authorize some relative or friend to look after his
commitment and, together with competent doctors, assume
the entire responsibility for depriving him of his liberty.
Though I have ventured one suggestion regarding com¬
mitments, I shall not at this time presume to attack the
problem involved. Its solution can come only after the
ablest members of the medical and legal professions have
given it the consideration it deserves.

O

During the entire time that my delusions of persecution,
as they are called, persisted, I could not but respect the mind
which had laid out so comprehensive and devilishly ingenious
and, at times, artistic a “Third Degree,” as I was called
upon to bear. And an innate modesty (more or less fugi¬
tive since these peculiar experiences) does not forbid my
mentioning the fact that I still respect that mind.

Suffering, such as I endured during the month of August
in my own home, continued with gradually lessening force
during the eight months I remained in this sanatorium.
Nevertheless my suffering during the first four of these eight
months was intense. All my senses were still perverted. My
sense of sight was the first to right itself nearly enough, at
least, to rob the detectives of their moving pictures. But, be¬
fore the last fitful film had run through my mind, I beheld
one which I shall now describe. I can trace it directly to
an impression made on my memory about two years earlier,
when I was still sane.

Shortly after going to New York to live I had explored the
Eden Musde. One of the most grewsome of the spectacles
which I had seen in its famed Chamber of Horrors was a
representation of a gorilla, holding in its arms the gory body
of a woman. It was that impression which now revived

A MIND THAT FOUND ITSELF

39

in my mind. But, by a process strictly in accordance with
Darwin’s theory, the Eden Musee gorilla had become a man

_ in appearance, not unlike the beast that had inspired my

distorted thought. This man held a bloody dagger which
he repeatedly plunged into the woman’s breast. The appa¬
rition did not terrify me at all. In fact I found it interesting,
for I looked upon it as a contrivance of the detectives. Its
purpose I could not imagine, and it distressed me the less
as I reasoned that no additional criminal charges could make
my situation worse than it already was.

For a month or two, “false voices” continued to annoy
me. And if there is a hell conducted on the principles of my
temporary hell, gossipers will one day wish they had attended
strictly to their own business. This is not a confession. I
am no gossiper, though I cannot deny that I have occa¬
sionally gossiped — a little. And this was my punishment :
persons in an adjoining room seemed to be repeating with
reference to me the very same things which I had said of
others on these communicative occasions. I supposed that
those whom I had talked about had in some way found me
out, and intended now to take their revenge. If all makers
of idle talk could be put through such a corrective course,
idle talkers would be abolished from the earth.

My sense of smell, too, became normal; but my sense
of taste was slow in recovering. At each meal, poison was
still the piece de resistance , and it was not surprising that I
sometimes dallied one, two, or three hours over a meal, and
often ended by not eating it at all.

There was, however, another reason for my frequent
refusal to take food, in my belief that the detectives had
resorted to a more subtle method of detection. They now
intended by each article of food to suggest a certain idea,
and I was expected to recognize the idea thus suggested.

40

A MIND THAT FOUND ITSELF

Conviction or acquittal depended upon my correct interpre¬
tation of their symbols, and my interpretation was to be
signified by my eating, or not eating, the several kinds of
food placed before me. To have eaten a burnt crust of
bread would have been a confession of arson. Why?
Simply because the charred crust suggested fire; and, as
bread is the staff of life, would it not be an inevitable
deduction that life had been destroyed — destroyed by fire
— and that I was the destroyer? On one day to eat a
given article of food meant confession. The next day, or
the next meal, a refusal to eat it meant confession. This
complication of logic made it doubly difficult for me to
keep from incriminating myself and others.

It can easily be seen that I was between several devils and
the deep sea. To eat or not to eat, perplexed me more than
the problem conveyed by a few shorter words perplexed a
certain prince, who, had he lived a few centuries later (out
of a book) might have been forced to enter a kingdom where
kings and princes are made and unmade on short notice.
Indeed, he might have lost his principality entirely — or,
at least, his subjects; for as I later had occasion to observe,
the frequency with which a dethroned reason mounts a throne
and rules a world is such that self-crowned royalty in asylums
for the insane receives but scant homage from the less elated
members of the court.

For several weeks I ate but little. Though the desire for
food was not wanting, my mind (that dog-in-the-manger)
refused to let me satisfy my hunger. Coaxing by the attend¬
ants was of little avail; force was usually of less. But the
threat that liquid nourishment would be administered
through my nostrils sometimes prevailed, for the attribute
of shrewdness was not so utterly lost that I could not choose
the lesser of two evils.

A MIND THAT FOUND ITSELF

4i

What I looked upon as a gastronomic ruse of the detec¬
tives sometimes overcame my fear of eating. Every Sunday
ice-cream was served with dinner. At the beginning of the
meal a large pyramid of it would be placed before me in a
saucer several sizes too small. I believed that it was never
to be mine unless I first partook of the more substantial
fare. As I dallied over the meal, that delicious pyramid
would gradually melt, slowly filling the small saucer, which
I knew could not long continue to hold all of its original
contents. As this liquefying process advanced I became
more indifferent to my eventual fate; and, invariably, before
a drop of that precious reward had dripped from the saucer,
I had eaten enough of the dinner to prove my title to the
seductive dessert. Moreover, during its enjoyment, I no
longer cared a whit for charges or convictions of all the
crimes on the calendar. This fact is less trifling than it
seems; for it proves the value of strategy as opposed to
brute and sometimes brutal force, of which I shall presently
give some illuminating examples.

VII

For the first few weeks after my arrival at the sanatorium,

I was cared for by two attendants, one by day and one by
night. I was still helpless, being unable to put my feet out
of bed, much less upon the floor, and it was necessary
that I be continually watched, lest an impulse to walk should
seize me. After a month or six weeks I grew stronger, and
from that time had but one attendant, who was with me all
day, and, at night, slept in the same room.

The earliest possible dismissal of one of my two attendants
was expedient for the family purse; for the charges at this,
as at all other sanatoriums operated for private gain, are
nothing less than extortionate. But such are the deficiencies
in the prevailing treatment of the insane that relief in one
respect occasions evil in another. No sooner was the num¬
ber of attendants thus reduced than I was subjected to a
detestable form of restraint which amounted to torture. To
guard me against myself while my remaining attendant slept,
my hands were imprisoned in what is known as a “muff.

A “muff,” innocent enough to the eyes of those who have
never worn one, is in reality a relic of the Inquisition. It
is an instrument of restraint which has been in use for cen¬
turies among ignorant practitioners, and even in many of
our public and private institutions is still in use. Such an
incident as I am about to recount cannot occur in a properly
conducted institution, and that fact made its occurrence a
crime, though perhaps an unintentional one; for good
motives born of professional ignorance are little, if at all,

42

A MIND THAT FOUND ITSELF

43

better than deliberate bad intention. The muff I wore was
made of canvas, and differed in construction from a muff
designed for the hands of fashion only in the inner partition,
also of canvas, which separated my hands but allowed
them to overlap. At either end was a strap which buckled
tightly around the wrist and was locked.

The assistant physician, when he announced to me that
I was to be subjected every night to this restraint, broke the
news gently — so gently that I did not then know, nor did I
guess for several months, why this thing was done to me.
And thus it was that I drew deductions of my own which
added not a little to my torture. I have already suggested
that an insane person should be treated as sane in all the
ways that are possible. It is a mistaken delicacy of feeling
which impels doctors and others in charge to avoid any direct
reference to a patient’s insanity in the presence of the patient
himself. I believe it would have mitigated my distress to
have been told in plain English that I was insane and had,
because of that condition, attempted suicide. To be sure I
should perhaps have regarded those about me as sullering
under a strange delusion, but I believe that the reason for
their behavior would have wormed its way into my under¬
standing months earlier than it did.

However, the physician in charge was really trying, so far
as he knew how, to do a very disagreeable thing as delicately
as possible. The gas-jet in my room was situated at a dis¬
tance, and stronger light was needed to find the keyholes
and lock the muff when adjusted. Hence, an attendant
was standing by with a lighted candle. Seating himself on
the side of the bed the physician said: “You won’t try again
to do what you did in New Haven, will you?” Now one
may have done many things in a city where he has lived for
a score of years, and it is not surprising that I failed to catch

44

A MIND THAT FOUND ITSELF

the meaning of the doctor’s question. It was only after
months of secret puzzling that I at last did discover his refer¬
ence to my attempted suicide. But now the burning candle
in the hands of the attendant, and a certain similarity be¬
tween the doctor’s name and the name of a man once accused
of arson, led me to imagine that in some way I had been
Connected with that crime; and for months I firmly believed
I stood charged as an accomplice.

The putting on of the muff was the most humiliating in¬
cident of my life. The shaving of my legs and the wearing
on my brow of the court-plaster brand of infamy had been
humiliating, but those experiences had not overwhelmed my
very heart as did this bitter ordeal. I resisted weakly, and,
after the muff was adjusted and locked, for the first time
since my mental collapse, I wept. And I remember distinctly
why I wept. The key that locked the muff unlocked in
imagination the door of the home in New Haven which I be¬
lieved I had disgraced, — and seemed for a time to unlock
my heart. Anguish beat my mind into a momentary sanity,
and with a wholly sane emotion I keenly felt my imagined
disgrace. As is usual under such circumstances my thoughts
centered on my mother. Her (and other members of
the family) I could plainly see at home in a state of dejection
and despair over her imprisoned and heartless son. I wore
the muff each night for several weeks, and for the first few
nights the unhappy glimpses of a ruined home recurred and
increased my suffering.

It was not always as an instrument of restraint -that the
muff was employed. Frequently it was used as a means of
discipline, on account of supposed stubborn disobedience to
the attendant. Many times was I roughly overpowered by
two attendants who locked my hands and coerced me to
do whatever I had refused to do. My arms and hands were

A MIND THAT FOUND ITSELF

45

my only weapons of defense. My feet were still in plaster
casts, and my back had been so severely injured as to neces¬
sitate my lying flat upon it most of the time. It was so
that these unequal fights were fought. And I had not even
the satisfaction of tongue-lashing my oppressors for I was
practically speechless.

My attendants, like most others in such institutions, were
ill-qualified to understand the operations of my mind, and
what they could not understand they would seldom tolerate.
Yet they were not entirely to blame. They were simply
carrying out to the letter, orders which they had received
from the doctors. In fact one of these attendants later
became so disgusted with the continued exercise of unfair¬
ness toward me that he secretly favored me by refraining
from force when I refused to do certain things which he
knew would annoy and distress me.

To ask a patient in my condition to take a little medicated
sugar seemed reasonable. I concede that; and my refusal
was exasperating. Had I been in the place of my keepers,
and they in mine, I might have acted no more wisely than
they. But, from my point of view, my refusal was justifiable.
That innocuous sugar disc to me seemed saturated with the
blood of loved ones; and so much as to touch it was to shed
their blood — perhaps on the very scaffold on which I was
destined to die. For myself I cared little. I was anxious
to die, and eagerly would I have taken the sugar disc had I
had any reason to believe that it was deadly poison. The
sooner I could die and be forgotten the better for all with
whom I had ever come in contact. To continue to live
was simply to be the treacherous tool of unscrupulous detec¬
tives, eager to exterminate my innocent relatives and
friends, if so their fame could be made secure in the annals
of their craft.

46

A MIND THAT FOUND ITSELF

But the thoughts associated with the taking of the medicine
were seldom twice alike. If, before it, something happened
to remind me of mother, father, a relative, or a friend, I
imagined that compliance would compromise, if not even¬
tually destroy, that particular person. Who would not
resist when meek acceptance would be a confession which
would doom his own mother or father to prison, or ignominy,
or death ? It was for this that I was reviled, for this, sub¬
jected to cruel restraint.

Let those in charge of such institutions, who have a stub¬
born patient to deal with, remember what I say. In the
strict sense of the word there is no such thing as a
genuinely stubborn insane person. The stubborn men
and women in the world are sanej and the fortunate
prevalence of sanity may be approximately estimated by
the preponderance of stubbornness in society at large.
When one possessed of the blessed means of resolving
his own errors continues to cherish an unreasonable be¬
lief _ that is stubbornness. But for a man bereft of reason
to adhere to an idea which to him seems absolutely correct
and true because he has been deprived of the means of detect¬
ing his error — that is not stubbornness. It is a symptom
of his disease, and merits the indulgence of forbearance, if
not genuine sympathv. Certainly the afflicted one dcser\es
no punishment. As well punish with a slap the cheek that
is disfigured by the mumps.

The attendant who was with me most of the time that I
remained at the sanatorium was a young man of about my
own age. He had never before worked in an institution of
that character, though he had acted as a nurse and com¬
panion in cases where the patient could be treated at home.
Him I regarded as a detective, or, rather, as two detectives,
one of whom watched me by day, and the other a perfect

A MIND THAT FOUND ITSELF

47

double — by night. He was an enemy, and his professed
sympathy — which I now know was genuine — only made
me hate him the more. As he was ignorant of the methods
of treatment in vogue in hospitals for the insane it was several
weeks before this exceptional attendant dared put in jeop¬
ardy his position by presuming to shield me against unwise
orders of the doctors. But when at last he awoke to the
situation he repeatedly interposed in my behalf. More
than once the doctor who was both owner and superintend¬
ent, threatened to discharge him for alleged officiousness.
But better judgment usually held the doctor’s wrath in
check, for he realized that not one attendant in a hundred
was so competent. It was indeed contrary to custom (for
in this matter attendants are unlike trained nurses in general
hospitals) that this attendant should take a lively personal
interest in me. Surely it was not the paltry and insulting
four and a half dollars a week that induced him to work
under such doctors, and in an institution which he de¬
tested. Such orders as he modified were without exception
unfair, and for exercising his superior judgment he deserves
no criticism. He was unconsciously an advocate of Non-
Restraint, working in an institution where Restraint was
tolerated and pretty freely used. Naturally there was
friction, for Restraint is as a cinder in the eye of one
who appreciates the advantages of humane treatment.

Not only did my attendant frequently exhibit more wis¬
dom than the superintendent, but he also obeyed the dictates
of a better conscience than that of his nominal superior, the
assistant physician, as the following incident will prove.
On three occasions this assistant physician treated me with
a signal lack of consideration, and in at least one instance
he was vicious. When this latter incident occurred I was,
both physically and mentally, helpless. My feet were swollen

48

A MIND THAT FOUND ITSELF

and still in plaster bandages. I was all but mute, uttering
only an occasional expletive when forced to do things against
my will.

One morning Doctor No-name (he represents a type) en¬
tered my room.

“Good-morning! How are you feeling?” he asked.

No answer.

“Aren’t you feeling well?”

No answer.

“Why don’t you talk?” said he with irritation.

Still no answer, except perhaps a contemptuous look such
as is so often the essence of eloquence. Suddenly, and with¬
out the slightest warning, as a petulant child locked in a room
for disobedience might treat a pillow, he seized my arm and
jerked me from the bed. It was wonderful that the bones of
my ankles and feet, not yet thoroughly knitted, were not
again broken. And this was the performance of the very
man who had locked my hands in the “muff, that I
might not injure myself!

I uttered not a word, — not even the usual automatic
expletive.

“Why don’t you talk?” he again asked.

Though rather slow in replying (it has now been over
seven years), I will take pleasure in doing so by sending that
doctor a copy of this book — my answer if he will but
send me his address. This physician left the sanatorium
about two years after I did. 1 hat such a man could con¬
tinue in so responsible a position, for so long, indicates the
little care generally exercised by owners of sanatoriums in
the selection of their assistants.

It is not a pleasant duty to brand any physician for cruelty
and incompetence, for the worst that ever lived has un¬
doubtedly done many good deeds. But here is the type of

A MIND THAT FOUND ITSELF

49

man that has wrought havoc among the helpless insane —
a type which unfortunately is still too often found (only not
found soon enough) in our private and public institutions.
It therefore seems but fair that the men whose destiny put
them in touch with one who has lived to publish his story
should at least bear the brunt of illustration.

S

VIII

My escape from death when I dropped from the window
is hardly more remarkable than the perfect present condi¬
tion of my feet and ankles, which were that day so seriously
injured. The fact that I am not now a cripple I ascribe to
two causes. First: to God — or Providence, or Fate, or luck,
if you choose. And second: such earthly praise as may be
properly bestowed belongs to the physician wTho, with con¬
summate skill, set my broken bones.

It was at the sanatorium that my ankles were finally re¬
stored to a semblance of their former utility. They were
there subjected to a course of heroic treatment; but as to-day
they permit me to walk, run, and dance, as those do who
have never been crippled, my hours of torture endured under
my first attempts to walk are almost pleasant to recall.
About five months from the date of my fall I was allowed,
or rather compelled, to place my feet on the floor and at¬
tempt to walk. They were still swollen, absolutely with¬
out action, and acutely sensitive to the slightest pressure.
From the time my feet were injured, until I again began
to talk — two years later — I asked not one question as to
the probability of my ever regaining the use of them. The
fact was, I never expected to walk naturally again. The
doctor’s desire to have me walk I believed to be inspired by
the detectives, of whom, indeed, I supposed the doctor him¬
self to be one. Had there been any confession to make I
am sure it would have been yielded under the stress of this
ultimate torture. The million needle points which, just

5°

A MIND THAT FOUND ITSELF

51

prior to my mental collapse, seemed to goad my brain, now
centered their unwelcome attention on the soles of my feet.
Had the floor been studded with minute stilettoes my suffer¬
ings could hardly have been more intense. For several weeks
assistance was necessary with each attempt to walk, and
each attempt was an ordeal. Every drop of blood in my
body seemed to find an irresistible attraction at the points
of pain. Sweat stood in beads on either foot, wrung from
my blood by agony. Believing that it would be only a
question of time when I should be tried, condemned, and
executed for some one of my countless felonies, I looked
upon the attempt to prevent my continuing a cripple for
the brief remainder of my days as prompted by anything
but benevolence.

I find no fault with the heroic treatment which necessi¬
tated the bearing of my weight on my feet at that time; but
I do think the superintendent of this sanatorium would have
proved himself more humane had he not peremptorily or¬
dered my attendant to discontinue the use of a support which,
until the plaster bandages were removed, had enabled me
to keep my legs in a horizontal position during those hours
of the day that I sat in a chair. His order was that I
should put my legs down and keep them down, whether it
caused me suffering or not. The pain was of course intense
when the blood again began to circulate freely through tis¬
sues long unused to its full pressure, and so evident was
my distress that the attendant disregarded the doctor’s com¬
mand.1 He would remove the forbidden support for only a
few minutes at a time, gradually lengthening the intervals
until at last I was able to do without the support entirely.
But, while favoring me, he had to remain on watch to guard

1 I am here corroborated by the sworn statement of the attendant who has
given me an affidavit which covers all incidents in which he played a part.

52

A MIND THAT FOUND ITSELF

against discovery. Each day for several weeks I was forced
at first to stagger and finally to walk across the room and
back to the bed. The distance was increased as the pain
diminished, until I was able to walk without more discomfort
than a comparatively pleasant sensation of lameness. For
at least two months after I first touched my feet to the floor
attendants had to carry me up and down stairs, and for
several months longer I went flat-footed.

Delusions of persecution — which include “delusions of
self -reference” — though a source of annoyance while I was
in an inactive state, annoyed and distressed me even more
when I began to move about and was obliged to associate
with other patients. To my mind not only were the doctors
and attendants detectives; each patient was a detective and
the whole institution was a part of the “Third Degree.”
Scarcely any remark was made in my presence that I could
not twist into a cleverly veiled reference to myself. In each
person I could see a resemblance to persons I had known, or
to the principals or victims of the crimes with which I
imagined myself charged. I refused to read, for to read
veiled charges and fail to assert my innocence was to
incriminate both myself and others. But I looked with
longing glances upon all printed matter and, as my curiosity
was continually piqued, this enforced abstinence grew to be
well-nigh intolerable.

It became again highly expedient to the family purse, upon
which my illness was so serious a drain, that every possible
saving be made. Therefore I was transferred from the main
building, where I had a private room and a special attend¬
ant, to a ward where I was to mingle, under an aggregate
sort of supervision, with fifteen or twenty other patients.
Here I had no special attendant by day, though one slept
in my room at night.

A MIND THAT FOUND ITSELF

53

Of this ward I had heard alarming reports — and these
from the lips of several attendants. I was therefore greatly
disturbed at the proposed change. But, the transfer once
accomplished, after a few days I really liked my new quar¬
ters better than the old. During the entire time I remained
at the sanatorium I was more alert mentally than I gave
evidence of being. But not until after my removal to this
ward where I was left alone for hours every day did I dare
to give evidence of my alertness. Here I even went so far
on one occasion as to joke with my new attendant. He
had been trying to persuade me to take a bath. I refused,
mainly because I did not like the looks of the bath-room,
which, with its cement floor and central drain, resembled
the washing-room of an improved stable. After all else
had failed the attendant tried the role of sympathizer.

“Now I know just how you feel,” said he, “I can put
myself in your place.”

“Well, if you can, do it and take the bath yourself,” said I.

The remark is brilliant by contrast with the dismal source
from which it escaped. “Escaped” is the word, for the
fear that I should hasten my trial by exhibiting too great a
gain in health, mental or physical, was already upon me; and
it controlled much of my conduct during the succeeding
months of despondency.

Having now no special attendant I spent many hours in
my room, alone, but not absolutely alone, for somewhere
the eye of a detective was evermore upon me. I soon
fancied that my case had been transferred from the State
to the Federal authorities, and the fear of an all-powerful
Secret Service did not tend to ease my laboring imagination.
Comparative solitude, however, gave me courage and soon
I began to read, regardless of consequences. During the
entire period of my depression, every publication seemed to

54

A MIND THAT FOUND ITSELF

have been written and printed for me, and me alone. Books,
magazines, and newspapers seemed to be special editions.
The fact that I well knew how inordinate would be the cost
of such a procedure in no way shook my faith in it. In¬
deed, that I was costing my persecutors fabulous sums of
money was a source of secret satisfaction a psychological
phenomenon, perhaps associated with delusions of grandeur
which long afterwards asserted themselves. During the earli¬
est stages of my illness I had lost count of time, and the
calendar did not right itself until the day when I largely
regained my reason. Meanwhile, the date on each newspaper
was, according to my reckoning, two weeks out of the way.
This confirmed my belief in the special editions as a part of
the “Third Degree.”

Most sane people think that no insane person can reason
logically. But this is not so. Upon unreasonable prem¬
ises I made most reasonable deductions, and that at the time
when my mind was in its most disturbed condition. Had
the papers which I read on the day which I supposed to be
February ist borne a January date, I might not then, for
so long a time, have believed in a special edition. Probably
I should have inferred that the regular editions had been
held back. .But the papers I had were dated about two
weeks ahead. Now if a sane person on February ist re¬
ceive a newspaper dated February 14th, he will be fully jus¬
tified in thinking something wrong, either with the paper or
with himself. But the shifted calendar which had planted
itself in my mind meant as much to me as the true calendar
does to any sane business man. During the seven hundred
and ninety-eight days of depression I drew countless incor¬
rect deductions. But such as they were they were deduc¬
tions, and the mental process was not other than that which
takes place in a well-ordered mind.

A MIND THAT FOUND ITSELF

55

My gradually increasing vitality, although it increased my
fear of trial, impelled me to take new risks. I began to
read not only newspapers, but also such books as were placed
within my reach. Yet had they not been placed there I should
have gone without them, for I would never ask even for
what I greatly desired and knew I could have for the asking.

Whatever love of literature I now have dates from this
time, when I was a mental incompetent and confined. Lying
on a shelf in my room was a large volume of George Eliot’s
works. For several days I cast longing glances at the book
and finally plucked up the courage to take little nibbles now
and then. These were so good that I grew bold and at last
began to read the book openly. Its contents at the time
made but little impression on my mind, but I enjoyed it. I
read also some of Addison’s essays; and had I been fortunate
enough to have read these earlier in life I might have been
spared the delusion that I could detect in many passages the
altering hand of my persecutors.

The friendly attendant, from whom I was now separated,
tried upon all occasions to send his favors after me into my
new quarters. At first he came in person to see me, but the
superintendent soon forbade that, and also ordered him not
to communicate with me in any way. It was this, and other
differences naturally arising between such a doctor and such
an attendant, that soon brought about the discharge of the
latter. But “ discharge” is hardly the word, for the attendant
had become disgusted with the institution, and had remained
so long only because of his interest in me. When he left, he
informed the owner that he would soon cause my removal
from the institution. This he did. He persuaded my rela¬
tives to let him care for me in his own home. I left the sana-

56 A MIND THAT FOUND ITSELF

torium in March, 1901, and remained for three months in the
home of my former attendant who lived with a grandmother
and an aunt in a small town not far from New Haven.

It is not to be inferred that I entertained any affection for
my friendly keeper. I continued to regard. him_as an enemy;
and my life at his home became a monotonous round of
displeasures. I took my three meals a day. I would sit
listlessly for hours at a time in the house. Daily I went out

— attended, of course — for short walks about the town.
These were not enjoyable. I believed everybody was
familiar with my black record and expected me to be put to
death. Indeed, I wondered why passers-by did not revile or
even stone me. Once I was sure I heard a little girl call me
“Traitor!” That, I believe, was my last “false voice,” but
it made such an impression that I can even now recall
vividly the appearance of that dreadful child.

During these three months I again refused to read books,
though they were within reach, and I returned to newspapers

— probably because I feared to indicate too much impro\ e-

ment and thus hasten my trial.

My attendant and his relatives were very kind and very
patient — for I was still intractable. But their efforts to
make me comfortable, so far as they had any effect, made
keener my desire for death at my own hands. I shrank
from death; — but I preferred to die by my own hand and
take the blame for it, rather than to be executed and bring
lasting disgrace on my family, friends, and 1 may add \\ ith
truth, on Yale. For I reasoned that parents throughout the
country would withhold their sons from a university which
numbered among its graduates such a despicable being as I.
But from any tragic act I was providentially restrained by the
very delusion which gave birth to the desire, — in a way which
signally appeared on a later and, to me, memorable day.

IX

I am in a position not unlike that of a man whose obituary
notice has appeared prematurely. Few men have ever had
a better opportunity than I to test the quality of their rel¬
atives’ affection, and similarly to test their friends. That
my relatives and friends did their duty and did it willingly
is naturally a constant source of satisfaction to me. Indeed,
I believe that that unbroken record of devotion is one of the
factors which have made it possible for me to take up again
my duties in the social and business world with a comfort¬
able feeling of continuity. I can now view my past with as
much complacency as does the man whose life has been uni¬
formly uneventful.

As I have seen scores of insane persons neglected by their
relatives — a neglect which recovered patients resent and
often brood upon — my sense of gratitude is the livelier, and
especially so because of the difficulty with which friendly in¬
tercourse with me was maintained during two of the three
years I was ill. Relatives and friends frequently called to see
me. True, these calls were trying for all concerned. I spoke
to none, not even to my mother and father. For, though they
all appeared about as they used to appear, I was able to de¬
tect some slight difference in look or gesture, and this was
enough to confirm my belief that they were impersonators,
engaged in a conspiracy, not merely to entrap me, but to
incriminate those whom they impersonated. It is not
strange, then, that I refused to have anything to say to them,
or to permit them to come near me. To have kissed the

57

58

A MIND THAT FOUND ITSELF

woman who was my mother, but whom I believed to be a
Federal conspirator, would have been an act of betrayal.
These interviews were much harder for my relatives and
friends than for me. But even to me they were in the nature
of ordeals; and though I suffered less at these particular
moments than my callers did, my sum of suffering was greater,
for I was constantly anticipating these unwelcome but event¬
ually beneficial visitations.

Suppose my relatives and friends had held aloof during
this apparently hopeless period, what to-day would be my
feelings toward them? Let others answer. For over two
years I considered all letters forgeries. Yet the day came
when I convinced myself of their genuineness and the gen¬
uineness of the love of those who sent them. Perhaps some
of the persons related to the twTo hundred thousand victims of
insanity in this country to-day will find some comfort in this
fact. To be on the safe and humane side let every sane rel¬
ative and friend of persons so afflicted remember the Golden
Rule, which has never been suspended with respect to the
insane. Go to see them, with as much of the light of sanity
as you possess; treat them sanely, write them sane letters,
keep them informed about the home-circle; let not your devo¬
tion flag, nor accept any repulse. There is a sure reward
sometime — somewhere.

The consensus of opinion now was that my condition was
unlikely ever to improve, and the question of my commit¬
ment to some institution where incurable cases could be
treated came up for decision. While it was being consid¬
ered my attendant kept assuring me that it would be unnec¬
essary to commit me to an institution if I would only show
some improvement. For that purpose he repeatedly sug-

A MIND THAT FOUND ITSELF

59

gested that I go to New Haven and spend a day at home.
I did finally indicate my willingness to make the trip; and
nothing proves more conclusively my dread of a hospital
for the insane than my action that day. I did not wish to
go to New Haven. I dreaded doing so. To my best knowl¬
edge and belief I had no home there, nor did I have any
relatives or friends who would greet me upon my return.
How could they, if still free, even approach me, while I was
surrounded by detectives? Then, too, I had a lurking sus¬
picion that my attendant’s offer was made in the belief that
I would not dare accept it. By taking him at his word I
knew that I should at least have an opportunity to test the
truth of many of his statements regarding my old home. Life
had become insupportable; and back of my consent to return
was a willingness to beard the detectives in their own den,
regardless of consequences. With these and many other
reflections I started for the train. The events of the journey
which followed are of no moment. We soon reached the
New Haven station; and, as I had expected, no relative or
friend was there to greet us. This apparent indifference of
relatives seemed to support my suspicion that my attendant
had not told me the truth; but I found little satisfaction in
uncovering his deceit, for the more of a liar I proved him to
be, the worse would be my position. We walked to the front
of the station and stood there for almost half an hour. The
unfortunate but perfectly natural wording of a question
caused the delay.

“Well, shall we go home?” said my attendant.

How could I say “Yes”? I had no home. I feel sure
I should finally have said “No,” had he continued to put
the question in that form. Consciously or unconsciously,
however, he altered it. “Shall we go to 30 Trumbull
Street?” That was what I had been waiting for. Cer-

6o

A MIND THAT FOUND ITSELF

tainly I would go to the house designated by that number.
I had come to New Haven to see that house; and I had just
a faint hope that its appearance and the appearance of its
occupants might prove convincing.

At home my visit came as a complete surprise. I could
not believe that my relatives — if they were relatives — had
not been informed of my presence in the city, and their
words and actions upon my arrival confirmed suspicion and
killed the faint hope I had briefly cherished. My hosts were
simply the same old persecutors with whom I had already
had too much to do. Soon after my arrival dinner was
served. I sat at my old place at the table, and secretly
admired the skill with which he who asked the blessing
imitated the language and the well-remembered intonation
of my father’s voice. But alas! for the family — I im¬
agined my relatives banished and languishing in prison,
and the old home confiscated by the government!

X

Though my few hours at home failed to prove that I did
not belong in an institution, it served one good purpose. Cer¬
tain relatives who had objected to my commitment now
agreed that there was no alternative, and, accordingly, my
eldest brother caused himself to be appointed my conservator.
He had long favored taking such action, but other relatives
counseled delay. They had been deterred by that inbred
dread of seeing a member of the family branded by law as a
mental incompetent, and, to a degree, stigmatized by an un¬
questionably mistaken public opinion. The very thought was
repugnant; and a mistaken sense of duty — and perhaps a
suggestion of pride — led them to wish me out of such an
institution as long as possible.

Though at the time I dreaded commitment, it was the best
possible thing that could befall me; and I wish to emphasize
this fact in order that others, situated as my relatives were,
may have fewer misgivings. In most instances an insane
person is more likely to recover in a reputable institution
than he is if kept in touch with the world he knew while
sane. To be in the world and not of it is exasperating. The
constant friction that is inevitable under such conditions —
conditions such as existed for me in the home of my attend¬
ant — can only aggravate the mental disturbance. Par¬
ticularly is this true of those laboring under delusions of
persecution. Such delusions multiply with the complexity of
the life led. It is the even-going routine of institutional life
which affords the indispensable quieting effect — provided

61

62

A MIND THAT FOUND ITSELF

that routine is well ordered, and not defeated by annoyances
imposed by ignorant or indifferent doctors and attendants.

My commitment occurred on June nth, 1901. The insti¬
tution to which I was committed is considered one of the
best of its kind in the country; and the conditions there are
to be found in a greater or less degree in most other such
institutions in every State in the Union. For that reason it is
not necessary that I name it. I am not writing an expose of
the three hospitals in which I was confined. The evils
they represent are almost universal, and I do not propose to
becloud the main issue, which is the need of a movement
to eliminate these evils everywhere. For this reason and,
in some instances, for charity’s sake, I suppress the names
of those who were in authority over me.

The institution itself was well situated. Though the
view was a restricted one, a vast expanse of lawn, surrounded
by groups of trees — patches of primeval forest — gave the
p'ace an atmosphere which was not without its remedial
value. My quarters were comfortable, and, after a little,
I adjusted myself to my new environment. A description
of the daily routine will, I believe, serve to dispel many mis¬
taken ideas regarding the life led by the inmates of such
institutions.

Breakfast was served about 7.30 a.m., though the hour
varied somewhat according to the season — earlier in sum¬
mer and later in winter. In the spring, summer, and fall,
when the weather was favorable, those able to go out of doors
were taken after breakfast for walks within the grounds, or
were allowed to roam about the lawn and sit under the trees,
where they remained for an hour or two at a time. Dinner
was usually served shortly after noon, and then the active
patients were again taken out of doors, where they remained
an hour or two doing much as they pleased, but under the

A MIND THAT FOUND ITSELF 63

eyes of attendants. About half-past three they returned to
their respective wards, there to remain until the next day
except those who cared to attend the religious service which
was held almost every afternoon in an endowed chapel.
Few such institutions in this country have religious services
every day. But Dr. Theodore B. Hyslop, Superintendent
of Bethlem Royal Hospital (London, England), a specialist
in neurology and in the treatment of mental diseases, goes
so far as to say: “Of all hygienic measures to counteract
disturbed sleep, depressed spirits, and all the miserable
sequels of a distressed mind I would undoubtedly give the
first place to the simple habit of prayer.”

Preachers of the gospel should appreciate this fact, and be
oftener seen working among the insane.

In all institutions those confined in different wards go to
bed at different hours. The patients in the best wards re¬
tire at nine or ten o’clock. Those in the wards where more
troublesome cases are treated go to bed usually at seven or
eight o’clock. I, while undergoing treatment, have retired
at all hours, so that I am in the better position to describe
the mysteries of what is, in a way, one of the greatest secret
societies in the world.

I soon became accustomed to the rather agreeable rou¬
tine, and began to enjoy life as much as a man could with the
cloud of death hanging over him, — for I still suffered the
constant dread of being removed to court, to prison, and to
the gallows or the electric-chair. But my living was hardly
life; yet, had I not been burdened with the delusions which
held me a prisoner of the police, and kept me a stranger to
my old world, I should have been able to enjoy a compara¬
tively happy existence in spite of all.

This new feeling of comparative contentment had not
been brought about by any decided improvement in health.

64

A MIND THAT FOUND ITSELF

It was due directly and entirely to an environment more
nearly in tune with my ill-tuned mind. While surrounded
by sane people my mental inferiority had been pain¬
fully apparent to me, as well as to others. Here a feeling
of superiority easily asserted itself, for many of my asso¬
ciates were, to my mind, vastly inferior to myself. But this
stimulus did not affect me at once. For several weeks I
believed the institution to be peopled by detectives, feigning
insanity. The government was still operating the “Third
Degree,” only on a grander scale. Nevertheless, I did soon
come to the conclusion that the institution was what it pro¬
fessed to be — still cherishing the idea, however, that cer¬
tain patients and attaches were detectives, — an idea which
persisted until my period of depression came to an end.
From June nth, 1901, when I first arrived at this hospital, to
August 30th, 1902, when the active and troublesome phase of
my illness began, I was treated with consideration by doc¬
tors and attendants alike. Fortunately, in all hospitals for
the insane, patients in a passive condition are pretty likely
to receive kind treatment.

For a while after my arrival I again abandoned my new¬
found reading habit. But as I became accustomed to my
surroundings I grew bolder and resumed my devotion
to the newspapers and to such books as were at hand. There
was a bookcase in the ward, filled with old numbers of
standard English periodicals; among them: Westminster Re¬
view, Edinburgh Review, London Quarterly, and Blackwood' s.
There were also copies of Harper's, Scribner's and The Atlan¬
tic Monthly, dated a generation or more before my first read¬
ing days. Indeed, some of the reviews were over fifty years
old. But I had to read their heavy contents or go without
reading, for I would not yet ask even for a thing I desired.
In the room of one of the patients were thirty or forty books

A MIND THAT FOUND ITSELF

65

belonging to him. Time and again I walked by his door and
cast a longing glance at those books, which at first I had not
the courage to ask for or to take. But during the summer,
about the time I was getting desperate, I finally managed to
summon enough courage to take books surreptitiously, and, I
confess, it was usually while the owner of these books was at¬
tending the daily service in the chapel that his library became
a circulating one.

Though this institution, unlike most institutions, had a
library, presented and endowed by a person interested in
the work that was being done there, that library, which was
kept in an adjoining ward, afforded me no pleasure until I
had become sane enough to ask for favors. Later investi¬
gation has convinced me that the libraries in existence
in hospitals for the insane are not made the most of; for it
frequently happens that those most desirous of reading are
least likely to ask for books. Instead of being kept in
one ward books should be distributed and re-distributed
throughout the several wards. The slight chance of their
being damaged or destroyed is more than offset by the good
they may do.

The contents of the books I read made perhaps more of
an impression on my memory than most books make on the
minds of normal readers. To assure myself of the fact I
have since re-read “The Scarlet Letter,” and I recognize
it as an old friend. The first part of the story, however,
wherein Hawthorne describes his work as a Custom House
official and portrays his literary personality, seems to have
made scarcely any impression. This I attribute to my utter
lack of literary interest at that time in writers and their
methods. I then had no desire to write a book, or any
thought of ever doing so. Not until the day I regained my
reason, were my literary ambitions born.

6

66

A MIND THAT FOUND ITSELF

Letters I looked upon with suspicion. I never read them
at the time they were received. I would not even open
them; but generally, after a week or sometimes a month, I
would secretly open and read them — forgeries of the
detectives.

I still refused to speak, and exhibited physical activity
only when the patients were taken out of doors. For hours
I would sit reading books or papers, or apparently doing
nothing. But my mind was in an active state and very
sensitive. As the event proved, everything done or said
within the range of my senses was making indelible impres¬
sions, though these at the time were frequently of such a char¬
acter that I experienced great difficulty in trying to recall
incidents which I thought I might find useful at the time of
my appearance in court.

My ankles had not regained anything like their former
strength. It hurt to walk. For months I continued to go
flat-footed. I could not sustain my weight with heels lifted
from the floor. In going down stairs I had to place my
insteps on the edge of each step, or go one step at a time,
like a child. Believing that the detectives were pampering
me into prime condition, as a butcher fattens a beast
for slaughter, I deliberately made myself out much weaker
than I really was; and not a little of my inactivity was due
to a desire to prolong my fairly comfortable existence, by
deferring as long as possible the day of trial and conspicuous
disgrace.

But my mode of living was not without its distressing
incidents. Whenever the attendants were wanted at the
office, an electric bell was rung. During the fourteen months
that I remained in this hospital in a depressed condition,
the bell in my ward rang several hundred times. Never
did it fail to send through me a mild shock of terror, for I

A MIND THAT FOUND ITSELF

67

imagined that at last the hour had struck for my transporta¬
tion to the scene of trial. Relatives and friends would be
brought to the ward — heralded, of course, by a warning
bell — and short interviews would be held in my room, dur¬
ing which the visitors had to do all the talking. My eldest
brother, whom I shall refer to hereafter as my conservator,
called often. He seldom failed to use one phrase which
annoyed and disturbed me.

“You are looking better and getting stronger,” he would
say. “We shall straighten you out yet.”

To be “straightened out,” was a phrase which had a cer¬
tain sinister ambiguity. It might refer to the end of the
hangman’s rope, or to a fatal electric shock. It would of
course be difficult to avoid all ambiguity of speech in talking
to one afflicted with delusions of persecution, but such care
as can be exercised would contribute to the patient’s peace
of mind.

I preferred to be let alone and the assistant physician in
charge of my case, after several ineffectual attempts to en¬
gage me in conversation, humored my persistent taciturnity.
For over a year nothing passed between us further than an
occasional conventional salutation. Subsequent events have
led me to doubt the wisdom of this policy, and to infer that
had my timid confidence once been gained some of my delu¬
sions might have been undermined, if not talked to death.
As I finally seduced my Unreason into at least a semblance
of sanity, by supplying myself with desired proofs as to the
genuineness of relatives and friends, is it not reasonable to
suppose that similar proofs, cleverly offered by others, might
have produced the same result earlier? Among psychi¬
atrists I find the opinion that it is only at an advanced stage
of recuperation that such an expedient would have any
chance of success; and that even in the event of success, the

68

A MIND THAT FOUND ITSELF

time so saved would scarcely be worth considering. Never¬
theless, instead of assuming that delusions must correct
themselves — if they are ever to be corrected — physicians
(more scrupulously, I think, than they do) might give the
patient the benefit of every doubt, and exercise their skill
from time to time to ascertain, if nothing more, whether or
not he exhibits signs of returning sanity. Of course, I will
not presume to combat the question pathologically. I am
only submitting for the consideration of psychiatrists an
impression gained from the inside.

For one year no further attention was paid to me than to
see that I had three meals a day, the requisite number of
baths, and a sufficient amount of exercise. I was, however,
occasionally urged by an attendant to write a letter to some
relative, but that, of course, I refused to do. As I shall have
many hard things to say about attendants in general, I take
pleasure in testifying that, so long as I remained in a pas¬
sive condition, those at this institution were kind, and at
times even thoughtful. But so soon as I regained, in a large
measure, my reason, and began to talk, diplomatic relations
with doctors and attendants became so strained that war
promptly ensued.

It was no doubt upon the gradual but sure improvement
in my physical condition that the doctors were relying for
my eventual salvation. They were not without some war¬
rant for this. In a way I had become less suspicious, but
my increased confidence was due as much to an increasing
indifference to my fate as to an improvement in health.
And there were other signs of improved mental vigor. I
was still watchful, however, for a chance to end my life,
and had I not largely regained my reason as soon as I did,
I do not doubt that my choice of evils would have found tragic
expression in an overt act.

A MIND THAT FOUND ITSELF

69

Having convinced myself that most of my associates were
really insane, and therefore (as I believed) disqualified as
competent witnesses in a court of law, I would occasionally
engage in conversation with a few whose evident incompe¬
tency seemed to make them safe confidants. One, a man
who during his life had suffered several nervous break¬
downs, more like acute nervous prostration than insanity,
took a very evident interest in me and persisted in talking to
me, often much against my will. His persistent inquisitive¬
ness seemed to support his own statement that he had for¬
merly been a successful life-insurance solicitor. He finally
gained my confidence to such a degree that months before I
finally began to talk to others I permitted myself to con¬
verse frequently with him — but only when we were so
situated as to escape observation. I would talk to him on
almost any subject except myself. At length, however, his
admirable persistence overcame my reticence. During a
conversation held in June, 1902, he abruptly said, “Why
you are kept here I cannot understand. Apparently you
are as sane as any one. You have never made any but
sensible remarks to me.” Now for weeks I had been waiting
for a chance to tell this man my very thoughts. I had come
to believe him a true friend who would not betray me.

“If I should tell you some things which you apparently
don’t know, you would understand why I am held here,”
said I.

“Well, tell me,” he urged.

“Will you promise not to repeat my statements to any one

else?”

“I promise not to say a word.”

“Well,” said I, “you have seen certain persons who have
come here, claiming to be relatives of mine.”

“Yes, and they are your relatives, aren’t they?”

7o

A MIND THAT FOUND ITSELF

“They look like my relatives, but they’re not,” was
my reply.

My inquisitive friend laughed aloud. “Well,” said he,
“if you mean that, I shall have to take back what I just
said. You are really the craziest person I have ever met,
and I have met several.”

“You will think differently some day,” said I; for I be¬
lieved that when my trial should occur he would appreciate
the significance of my statement. I did not tell him that I
believed these callers to be detectives; nor did I hint that I
thought myself in the hands of the police.

Meanwhile, during July and August, 1902, I redoubled
my activity in devising suicidal schemes; for I now thought
my physical condition satisfactory to my enemies, and was
sure that my trial could not be postponed beyond the next
opening of the courts in September. I even went so far as to
talk to one of the attendants, a medical student, who, during
the summer, worked as an attendant at the hospital. I
approached him artfully. First I asked him to procure
from the library for me “The Scarlet Letter,” “The House of
Seven Gables,” and other such books; then I talked med¬
icine and finally asked him to lend me a text-book on anat¬
omy which I knew he had in his possession. This he did,
cautioning me not to let any one know that he had clone so.
The book once secured, I lost no time in examining that
part which described the heart, its functions, and especially
its exact location in the body. I had scarcely begun to read
when the attendant returned and took the book from
me, offering as his reason that, as an attendant, he had no
right to give me a medical work. I have often wondered
since whether this was an intervention of Providence.

As is usual in institutions for the insane, all knives, forks,
and other articles, which might be used by a patient for

A MIND THAT FOUND ITSELF

71

an insane purpose, were counted by the attendants after
each meal. This I knew, and it had a deterrent effect. I
dared not take one. Though I might at any time during
the night have hanged myself, that method did not appeal
to me, and I kept it in mind only as a last resort. To get
possession of some sharp dagger-like instrument which I
could plunge into my heart at a moment’s notice — this was
my consuming desire. With such a weapon I felt that I
could, when the crisis came, rob the detectives of their vic¬
tory. During the summer months an employee spent his
entire time driving a large lawn-mower over the grounds.
This when not in use was often left outdoors. Upon it was
a square wooden box, containing certain necessary tools,
among them a sharp, spike-like instrument, used to clean the
oil-holes when they had become clogged. This bit of steel
was five or six inches long, and was shaped like a pencil.
For at least three months prior to the moment of my restored
reason I seldom went out of doors that I did not go with the
intention of purloining that steel spike. I intended then to
keep it in my room against the day of my anticipated trans¬
fer to jail.

It was now that my delusions protected me from the very
fate they had induced me to court. For had I not believed
that the eye of a detective was on me every moment, I could
have taken that spike a score of times. Often when it was
not in use I walked to the lawn-mower and even laid my
hand upon the tool-box. But I dared not open it. My
feelings were much like those of Pandora about a certain
other box. In my case, however, the box upon which I
looked with longing had Hope without, and not within.
Instinctively, perhaps, I realized this, for I did not lift
the lid.

One day, as the patients were returning to their wards, I

72

A MIND THAT FOUND ITSELF

saw, lying directly in my path (I could even now point out
the spot), the coveted weapon. Never have I seen anything
that I more desired. To have stooped and picked it up
without detection would have been easy; and had I known,
as I know now, that it had been carelessly dropped, nothing
could have prevented me from doing so and perhaps using
it with fatal effect. But I believed it had been placed there
deliberately and as a test, by those who had divined my
suicidal purpose. The eye of the imagined detective, which,
I am inclined to believe, and like to believe, was the eye of
the real God, was upon me; and though I stepped directly
over it I did not pick up that thing of death.

XI

When I had decided that my chance for securing the little
stiletto-spike was very imcertain, I at once busied myself
with plans which wTere designed to bring about my death
by drowning. There was in the ward a large bath-tub. Ac¬
cess to it could be had at any time, except between the hour
of nine at night (when the patients were locked in their
rooms) and the following morning. How to make it acces¬
sible in those dark hours was the problem which confronted
me. The attendant in charge was supposed to see that
each patient was in his room when the door was locked. As
it rarely happened that the patients were not in their rooms at
the appointed time, the attendants naturally grew careless, and
often locked a door without looking in. The “good night”
of the attendant, a salutation usually devoid of sentiment,
might, or might not, elicit a response, and the absence of a
response would not tend to arouse suspicion — especially
in a case like mine, for I would sometimes say “good night,”
but more often not.

My simple and easy plan was to hide behind a piece of
furniture in the corridor and there remain until the attend¬
ant had locked the doors of the rooms and retired. I
had even advanced so far in my plan as to select a con¬
venient place. This was a nook within twenty feet of my
own room. Should the attendant, when about to lock the
door, discover my absence, I should, of course, immediately
reveal my hiding-place by leaving it; and it would have been
an easy matter to convince him that I had done the thing as a

73

74

A MIND THAT FOUND ITSELF

test of his own vigilance. On the other hand, if I escaped
discovery, I should then have nine hours at my disposal
with little fear of interruption. True, the night-watch passed
through the ward once every hour. But death by drown¬
ing requires a time no longer than that necessary to boil an
egg. I had even calculated how long it would take to fill
the tub with water. To make sure of a fatal result, I had
secreted a piece of wire which I intended so to use that my
head, once under water, could by no possibility be raised
above the surface in the inevitable struggle.

I have said that I did not desire death; nor did I. Had
the supposed detectives been able to convince me that they
would keep their word, I would willingly have signed an
agreement stipulating on my side that I must live the rest
of my life as an inmate of an asylum, and on theirs that I
should never undergo a trial for crime.

Fortunately during these dismal preparations I had not
lost interest in other schemes which probably saved my life.
In these the fellow-patient who had won my confidence
played the r61e of my own private detective. That he and
I could defeat the combined forces of the Nation hardly
seemed probable, but the seeming impossibility of so doing
only lent zest to the undertaking. My friend, who, of course,
did not realize that he was engaged in combat with the Secret
Service, was allowed to go where he pleased within the limits
of the city where the hospital was situated. Accordingly
I determined to enlist his services. It was during July
that, at my suggestion, he tried to procure copies of certain
New Haven newspapers, of the date of my attempted suicide
and the several dates immediately following. My purpose
was to learn what motive had been ascribed to my suicidal
attempt. I felt sure that they would contain at least hints
as to the nature of the criminal charges against me. But this

A MIND THAT FOUND ITSELF

75

purpose I did not disclose to my friend. In due time he re¬
ported that no copies for the given dates were to be had.
So that quest proved fruitless, and I attributed the failure to
the superior strategy of the enemy.

Meanwhile, my friend had not desisted from his attempt
to convince me that my apparent relatives were not spurious;
and one day I said to him: “If my relatives still live in New
Haven, their addresses must be in the latest New Haven
Directory. Here is a list containing the names and former
addresses of my father, brother, and uncle. These were
their addresses in 1900. To-morrow, when you go out,
please see whether they appear in the New Haven Directory
for 1902. These persons who present themselves to me as
relatives pretend to live at these addresses. If they speak
the truth, the 1902 Directory will corroborate them. I will
then have hope that a letter sent to any one of these ad¬
dresses will reach relatives, — and surely some attention
will be paid to it.”

The next day, which was August 27th, my own good detec¬
tive went to a local publishing house where directories of
the several important cities throughout the country may be
consulted. Shortly after he went out upon this errand, my
conservator appeared. He found me walking about the lawn.
At his suggestion we sat down. Bold in the assurance that
I could kill myself before the crisis came, I talked with him
freely, replying to many of his questions and asking several.
My conservator, who had never fully understood that I de¬
nied his identity, commented with manifest pleasure on my
new-found readiness to talk. He would have been less
pleased, however, had he been able to read my mind.

Shortly after my conservator’s departure my fellow-patient
returned and informed me that the latest New Haven direc¬
tory contained the names and addresses I had given him.

76

A MIND THAT FOUND ITSELF

This information, though it did not prove that my morn¬
ing caller was no detective, did convince me that my real
brother still lived where he did when I left New Haven,
two years earlier. At this time my physical senses were less
perverted than they had been previously, and in that fact
lay my salvation. Now that my senses no longer lied to me,
my returning reason enabled me to construct the ingenious
scheme which, I believe, saved my life; for, had I not largely
regained my reason when I did, I am inclined to believe that
my distraught mind would have destroyed itself and me, be¬
fore it could have been restored by the slow process of re¬
turning health.

A few hours after my private detective had given me the
information I so much desired, I wrote my first letter in
twenty-six months. As letters go it is in a class by
itself. I dared not ask for ink, so I wrote with a lead pencil.
Another fellow-patient in whom I had confidence, at my
request, addressed the envelope; but he was not in the secret
of its contents. This was an added precaution, for I thought
the Secret Service men might have found out that I had a
detective of my own and would confiscate any letters ad¬
dressed by him or me. The next morning, my “detective”
mailed the letter. That letter I still have, and I treasure
it as any innocent man condemned to death would treasure
a pardon or reprieve. It should convince the reader that
sometimes an insane man can think and write clearly. An
exact copy of this — the most important letter I ever expect
to be called upon to write — is here appended :

August 29, 1902.

Dear George:

On last Wednesday morning a person who claimed to be George M. Beers
of New Haven, Ct., clerk in the Director’s Office of the Sheffield Scientific
School and a brother of mine, called to see me.

Perhaps what he said was true, but after the events of the last two years

A MIND THAT FOUND ITSELF

77

I find myself inclined to doubt the truth of everything that is told me. He
said that he would come and see me again sometime next week, and I am
sending you this letter in order that you may bring it with you as a passport,
provided you arc the one who was here on Wednesday.

If you did not call as stated please say nothing about this letter to any¬
one, and when your double arrives, I ’ll tell him what I think of him . Would
send other messages, but while things seem as they do at present it is im¬
possible. Have had some one else address envelope for fear letter might be
held up on the way. YoUrs,

Clifford W. B.

Though I felt reasonably confident that this message
would reach my brother, I was by no means certain. I was
sure, however, that, should he receive it, under no circum¬
stances would he turn it over to any one hostile to myself.
When I wrote the words: “Dear George,” my feeling was
much like that of a child who sends a letter to Santa Claus
after his faith in the existence of Santa Claus has been shaken.
Like the sceptical child, I felt there was nothing to lose, but
everything to gain. “Yours” fully expressed such affection
for relatives as I was then capable of, — for the belief that
I had disgraced, perhaps destroyed, my family prompted
me to forbear to use the family name in the signature.

The thought that I might soon get in touch with my old
world did not excite me. I had not much faith any¬
way that I was to re-establish former relations, and what
little faith I had was almost dissipated on the morning of
August 30th, 1902, when a short message, written on a
slip of paper, reached me by the hand of an attendant.
It informed me that my brother would call that afternoon.
I thought it a lie. I felt that any brother of mine would
have taken the pains to send a letter in reply to the first I
had written him in over two years. The thought that there
had not been time for him to do so and that this message
must have arrived by telephone did not then occur to me.

78

A MIND THAT FOUND ITSELF

What I believed was that my own letter had been confis¬
cated. I asked one of the doctors to swear on his honor
that it really was my own brother who was coming to see
me. He did so swear, and this may have diminished my
first doubt somewhat, but not much, for abnormal suspicion
robbed all men in my sight of whatever honor they may
have had.

The thirtieth of the month was what might he called a
perfect June day in August. In the afternoon, as usual, the
patients were taken out of doors, I among them. I wan¬
dered about the lawn, and cast frequent and expectant
glances toward the gate, through which I believed my antici¬
pated visitor would soon pass. In less than an hour he
appeared. I first caught sight of him about three hundred
feet away, and, impelled more by curiosity than hope, I
advanced to meet him. “I wonder what the lie will be this
time,” was the gist of my thoughts.

The person approaching me was indeed the counterpart of
my brother as I remembered him. Yet he was no more my
brother than he had been at any time during the preceding
two years. He was still a detective. Such he was when I
shook his hand. As soon as that ceremony was over he
drew forth a leather pocket-book. I instantly recognized
it as one I myself had carried for several years prior to
the time I was taken ill in 1900. It was from this that he
took my recent letter.

“Here’s my passport,” said he.

“It’s a good thing you brought it,” said I coolly, as I
glanced at it and again shook his hand — this time the hand
of my own brother.

“Don’t you want to read it?” he asked.

“There is no need of that,” was my reply. “I am con¬
vinced.”

A MIND THAT FOUND ITSELF

79

After my long journey of exploration in the jungle of a
tangled imagination, a journey which finally ended in my
finding the person for whom I had long searched, my be¬
havior differed very little from that of a great explorer who,
after a perilous trip through real jungles, found the man he
sought and, coolly grasping his hand, greeted him with a
now historic remark.

The very instant I caught sight of my letter in the hands
of my brother, all was changed. The thousands of false
impressions recorded during the seven hundred and ninety-
eight days of my depressed state seemed at once to correct
themselves. Untruth became Truth. A large part of
what was once my old world was again mine. To me, at
least, my mind seemed to have found itself, for the gigan¬
tic web of false beliefs in which I had all but hopelessly
enmeshed myself was immediately recognized by me as a
snare of delusions. That the Gordian knot of mental tor¬
ture should be cut and swept away by the mere glance of a
willing eye is like a miracle. Not a few patients, however,
suffering from certain forms of mental disorder, regain
a high degree of insight into their mental condition in
what might be termed a flash of divine enlightenment.
Though insight regained seemingly in an instant is a most
encouraging symptom, power to reason normally on all
subjects cannot, of course, be so promptly regained. My
regained power to reason correctly on some subjects sim¬
ply marked the transition from depression, one phase of
my disorder, to elation, another phase of it.

My memory during depression might be likened to a
photographic film, seven hundred and ninety-eight days
long. Each impression seems to have been made in a nega¬
tive way and then, in a fraction of a second, miraculously
developed and made positive. Of hundreds of impres-

8o

A MIND THAT FOUND ITSELF

sions made during that depressed period I had not before
been conscious, but from the moment I regained my rea¬
son they have stood out vividly. Not only so, but other
impressions gathered during earlier years have done
likewise. Since that August 30th, which I regard as my
second birthday (my first was on the 30th of another
month), my mind has exhibited qualities which, prior to
that time, were so latent as to be scarcely distinguishable.
As a result, I find myself able to do desirable tilings I never
before dreamed of doing — the writing of this book is one
of them.

Yet had I failed to convince myself on August 30th, when
my brother came to see me, that he was no spy, I am almost
sure that I should have compassed my own destruction
within the following ten days, for the next month, I believed,
was the fatal one of opening courts. It was death by drown¬
ing that impended. And I find it peculiarly appropriate
to liken my salvation itself to a prolonged process of drown¬
ing. Thousands of minutes of the seven hundred and
ninety-eight days — and there were over one million of
them, during which I had been borne down by intolerably
burdensome delusions — were, I imagine, much like the
last minutes of consciousness experienced by persons who
drown. Many who have narrowly escaped this fate can
testify to the vividness with which good and bad im¬
pressions of their entire life rush through their confused
minds, and hold them in a grip of terror until a kind uncon¬
sciousness envelopes them. Such had been many of my
moments. But the only unconsciousness which had dead¬
ened my sensibilities during these two despondent years
was the semi-unconsciousness of sleep itself. Though 1
slept well most of the time, mine was seldom a dreamless
sleep. Many of my dreams were, if anything, harder to

A MIND THAT FOUND ITSELF 81

bear than my delusions of the day, for what little reason I
had was absolutely suspended in sleep. Almost every
night my brain was at battledore and shuttlecock with
weird thoughts. And if not all my dreams were terrifying,
this fact seemed to be only because a perverted and per¬
verse Reason, in order that its possessor might not lose the
capacity for suffering, knew how to keep Hope alive with
visions which supplied the contrast necessary for keen
appreciation.

No man can be born again, but I believe I came as near
it as ever a man did. To leave behind what was in reality
a Hell, and, in less than one second, have this good green
earth revealed in more glory than most men ever see it,
was a compensating privilege which makes me feel that my
suffering was distinctly worth while. This statement will
no doubt seem extravagant to those who dread insanity;
but those who appreciate what a privilege it is to be placed
in a position to do great good, will, I am sure, credit me
with sincerity. For have I not before me a field of phi¬
lanthropy in which to work — a field which, even in this
altruistic age, is practically untouched?

I have already described the peculiar sensation which
assailed me when, in June, 1900, 1 lost my reason. At that
time my brain felt as though pricked by a million needles
at white heat. On this August 30th, 1902, shortly after
largely regaining my reason, I had another most distinct
sensation in the brain. It started under my brow and
gradually spread until the entire surface was affected.
The throes of a dying Reason had been torture. The
sensations felt as my dead Reason was reborn were delight¬
ful. It seemed as though the refreshing breath of some
kind Goddess of Wisdom were being gently blown against
the surface of my brain. It was a sensation not unlike

82

A MIND THAT FOUND ITSELF

that produced by a menthol pencil rubbed ever so gently
over a fevered brow. So delicate, so crisp and exhilarat¬
ing was it that words fail me in my attempt to describe it.
Few if any experiences can be more delightful. If the
exaltation produced by some drugs is anything like it, I
can easily understand how and why certain pernicious
habits enslave those who contract them. For me, however,
this experience was liberation, not enslavement.

XII

After two years of silence I found it no easy matter to
carry on with my brother a sustained conversation. So weak
were my vocal cords from lack of use that every few minutes
I must either rest or whisper. And, upon trying, I found
myself unable to whistle, notwithstanding the popular belief,
drawn from vague memories of small- boyhood, that this art
is instinctive. Those who all their lives have talked at
will cannot possibly appreciate the enjoyment I found in
using my regained power of speech. Reluctantly I returned
to the ward; but not until my brother had left for home,
laden with so much of my conversation that it took most of
his leisure for the next two days to tell the family what I
had said in two hours.

During the first few hours I seemed virtually normal.
I had none of the delusions which had previously oppressed
me; nor had I yet developed any of the expansive ideas, or
delusions of grandeur, which soon began to crowd in upon
me. So normal did I appear while talking to my brother
that he thought I should be able to return home in a few
weeks; and, needless to say, I agreed with him. But the
pendulum, as it were, had swung too far. The human
brain is too complex a mechanism to admit of any such
complete re- adjustment in an instant. It is said to be com¬
posed of several billion cells; and, that fact granted, it seems
safe to say that every day, perhaps every hour, hundreds of
thousands of those within my skull were now being brought

83

g4 A MIND THAT FOUND ITSELF

into a state of renewed activity. Comparatively sane and able
to recognize the important truths of life, I was yet insane as
to many of its practical details. Judgment being King of
the Realm of Thought, it was not surprising that my judg¬
ment failed often to decide correctly the many questions
presented to it by its abnormally communicative subjects.
At first I seemed to live a second childhood. I did with
delight many things which I had first learned to do as a
child — the more so as it had been necessary for me to
learn again how to eat and walk, and now how to talk. I
had much lost time to make up; and, for a while, my sole
ambition seemed to be to utter as many thousand words per
diem as possible. My fellow-patients who for fourteen
months had seen me walk about in silence - a silence so
profound and inexorable that I would seldom heed their
friendly salutations — were naturally surprised to see me
in my new mood of unrestrained loquacity and irrepres¬
sible good-humor. In short, I had come into that abnor¬
mal condition which is known to psychiatrists as “ elation.

For several weeks I believe I did not sleep more than two
or three hours of the twenty-four, each da\ . Such w as m}
state of elation, however, that all signs of fatigue were en¬
tirely absent; and the sustained and abnormal mental anc
physical activity, in which I then indulged, has le t on my
memory no other than a series of very pleasant impressions.
Though based on fancy the delights of madness are real.
Few, if any, sane persons would care to test the matter at so
great a price; but those familiar with the “ Letters of Charles
Lamb,” must know that Lamb himself, at one time during
his early manhood, underwent treatment for mental dis¬
ease. In a letter to Coleridge, dated June 10, 1796, be says
“At some future time I will amuse you with an accoun ,
as full as my memory will permit, of the strange turns my

A MIND THAT FOUND ITSELF

85

frenzy took. I look back upon it at times with a gloomy kind
of envy; for, while it lasted, I had many, many hours of pure
happiness. Dream not, Coleridge, of having tasted all the
grandeur and wildness of Fancy till you have gone mad!
All now seems to me vapid, comparatively so!”

As for me, the very first night vague and vast humanita¬
rian projects began joyously to shape themselves in my mind.
My garden of thoughts seemed filled with flowers which
might properly be likened to the quick-blowing, night-bloom¬
ing cereus — that Delusion of Grandeur of all flowering plants
that thinks itself prodigal enough if it but unmask its beauty
to the moon! Few of my bold fancies, however, were of so
fugitive and chaste a splendor.

The religious instinct is found in primitive man. It is
not strange, therefore, that at this time the religious side
of my nature was the first to display compelling activity.
Whether or not this was due to my rescue from a living death,
and my immediate appreciation of God’s goodness both to
me and to those faithful relatives who had done all the pray¬
ing during the preceding two years — this I cannot say.
But the fact stands out, that, whereas I had, while in the
depressed state, attached a sinister significance to every¬
thing done or said in my presence, I now interpreted the
most trifling incidents as messages from God. The day
after this transition I attended church. It was the
first service in over two years which I had not attended
against my will. The reading of a psalm — the 45th —
made a lasting impression upon me, and the interpretation
which I placed upon it furnishes the key to my attitude
during the first weeks of elation. It seemed to me a direct
message from Heaven.

The minister began: “My heart is inditing a good matter:
I speak of the things which I have made touching the King:

86

A MIND THAT FOUND ITSELF

my tongue is the pen of a ready writer.” — Whose heart but
mine ? And the things indited — what were they but the
humanitarian projects which had blossomed in my garden
of thoughts over night? When, a few days later, I found
myself writing very long letters with unwonted facility, I
became convinced that my tongue was to prove itself “the
pen of a ready writer.” Indeed, to these prophetic words
I trace the inception of an irresistible desire, of which this
book is the first fruit.

“Thou art fairer than the children of men: grace is poured
into thy lips:” was the verse next read, to which the minister
responded, “Therefore God hath blessed thee for ever.” —
“Surely,” thought I, “I have been selected as the instru¬
ment wherewith great reforms shall be effected.” (All is
grist that comes to the mill of a mind in elation, — then even
divine encomiums seem not undeserved.)

“Gird thy sword upon thy thigh, O most mighty, with
thy glory and thy majesty,” — a command to fight. “And
in thy majesty ride prosperously because of truth and meek¬
ness and righteousness;” replied the minister. “And thy
right hand shall teach thee terrible things,” read I. That
I could speak the truth, I knew. “Meekness” I could not
associate with myself, except that during the preceding
two years I had suffered many indignities without open re¬
sentment. That my right hand with a pen should teach me
terrible things — how to fight for reform — I firmly believed.

“Thine arrows are sharp in the heart of the King’s enemies,
whereby the people fall under thee,” quoth the minister.
Yes, my tongue could be as sharp as an arrow, and I should
be able to stand up against those who should stand in
the way of reform. Again: “Thou lovest righteousness,
and hatest wickedness. — Therefore God, thy God, hath
anointed thee with the oil of gladness above thy fellows.”

A MIND THAT FOUND ITSELF

87

The first sentence I did not apply to myself; but being then,
as I supposed, a man restored to himself, it was easy to feel
that I had been anointed with the oil of gladness above my
fellows. “Oil of gladness” is, in truth, an apt phrase
wherewith to describe “elation.”

The last two verses of the psalm corroborated the mes¬
sages found in the preceding verses: “I will make thy name
to be remembered in all generations:” — thus the minister.
“Therefore shall the people praise thee for ever and ever,”
was the response I read. That spelled immortal fame
for me, but only on condition that I should carry to a success¬
ful conclusion the mission of reform — an obligation placed
upon me by God when He restored my reason.

I know of no better way to convey to the reader my
state of mind during these first weeks of elation than to
confess — if confession it is — that when I set out upon a
career of reform I was impelled to do so by motives in
part like those which seem to have possessed Don Quixote
when he, madman that he was, set forth, as Cervantes
says, with the intention “of righting every kind of wrong,
and exposing himself to peril and danger, from which in
the issue he would obtain eternal renown and fame.” The
quoted passage, first read by me while preparing for publi¬
cation the printed proof of my manuscript, embodies the
very idea I had expressed months earlier, while writing the
paragraph which immediately precedes this one. In liken¬
ing myself to Cervantes’ mad hero my purpose is quite
other than to push myself within the charmed circle of the
chivalrous. What I wish to do is to make plain that one
abnormally elated may be swayed irresistibly by his best
instincts, and that while under the spell of an exaltation,
idealistic in degree, he may not only be willing, but eager
to assume risks and endure hardships which under normal

88

A MIND THAT FOUND ITSELF

conditions he would assume reluctantly, if at all. In jus¬
tice to myself, however, and lest I should do ‘‘the cause”
an injury, I feel privileged to remark that my plans for
reform have never assumed Quixotic, and therefore im¬
practicable, proportions. At no time have I gone a-tilting
at windmills. A pen rather than a lance has been my
weapon of offense and defense; for with its point I have
felt sure that I should one day prick the civic conscience
into a compassionate activity, and thus bring into a neg¬
lected field earnest men and women who should act as
champions for those afflicted thousands least able to fight
for themselves.

XIII

After being without relatives and friends for over two
years I naturally lost no time in trying again to get in touch
with them; — though I did heed my conservator’s request
that I first give him two or three days in which to acquaint
certain persons with the new turn my affairs had taken.

During the latter part of that first week I wrote many
letters, so many, indeed, that I soon exhausted a liberal
supply of stationery. This had been placed at my
disposal at the suggestion of my conservator, who had
wisely arranged that I should have whatever I wanted, if
expedient. It was now at my own suggestion that the super¬
visor gave me large sheets of manila wrapping paper. These
I proceeded to cut into strips a foot wide. One such strip,
four feet long, would suffice for a mere billet-doux; but a
real letter usually required several such strips pasted to¬
gether. More than once letters twenty or thirty feet long were
written; and on one occasion the accumulation of two or
three days of excessive productivity, when spread upon the
floor, reached from one end of the corridor to the other — a
distance of about one hundred feet. My output per hour
was something like twelve feet with an average of one hun¬
dred and fifty words to the foot. Under the pressure of
elation one takes pride in doing everything in record time.
Despite my speed, however, my letters were not incoherent.
They were simply digressive, which was to be expected, as
elation befogs one’s “goal idea.” Though these epistolary
monstrosities were launched, few reached their intended

89

9o

A MIND THAT FOUND ITSELF

addressees, for my conservator had wisely ordered that my
literary output be sent in bulk to him. This interference
was exasperating, but later I realized that my brother had
done me a great favor when he interposed his judgment
between my red-hot mentality and the cool minds of the
work-a-day world. Yet, this interference with what I
deemed my rights proved to be the first step in the general
overruling of them by tactless attendants and, in particular,
by a certain assistant physician.

All my life I have exhibited more than the average desire
to superintend ; and when a man is so constituted that he
knows — or thinks he knows — what he wants to do at any
present or future time, it is quite natural that he should give
more advice than he is willing to take. In my elated con¬
dition I had an excess of questionable executive ability; and
in order to decrease this executive pressure I proceeded to
assume entire charge of that portion of the hospital in v. hich
I happened at the moment to be confined. What I even¬
tually issued as imperative orders, at first were often pre¬
sented as suggestions. But my statements were usually
requests — my requests, demands; and, if my suggestions
were not accorded a respectful hearing, and my demands
acted on at once, I invariably substituted vituperative ulti¬
matums. These were double-edged, and involved me in
trouble quite as often as they gained the ends I had in view.

The assistant physician in charge of my case, realizing
that he could not grant all of my requests, unwisely decided
to deny most of them. Had he been tactful he could have
taken the same stand without arousing my animosity. As
it was, he treated me with a contemptuous sort of indiffer¬
ence which finally developed into spite, and led to much
trouble for us both. During the two wild months that
followed, the superintendent and the steward could induce

A MIND THAT FOUND ITSELF

91

me to do almost anything by simply requesting it. If two
men out of three could control me easily during such a period
of mental excitement, is it not reasonable to suppose that
the third man, the assistant physician, could likewise have
controlled me had he treated me with due consideration?
It was his undisguised superciliousness that gave birth to
my contempt for him. In a letter written during my second
week of elation, I expressed the opinion that he and I should
get along well together. But that was before I had become
troublesome enough to try the man’s patience. Neverthe¬
less, it indicates that this doctor could have saved himself
hours of time and subsequent worry had he met my friendly
advances in the proper spirit. Physicians throughout the
country engaged in work among the insane may profitably
take this observation to heart, — and “heart” I use advisedly,
for it is the quality of heart rather than the quantity of mind
that cures or makes happy the insane.

The literary impulse took such a hold on me that when I
first sat down to compose a letter I bluntly refused to stop
writing and go to bed when the attendant ordered me to do
so. For over one year this man had seen me mute and meek,
and the sudden and startling change from passive obedience
to uncompromising independence naturally puzzled him.
He threatened to drag me to my room, but strangely enough
decided not to do so. After half an hour’s futile coaxing,
during which time an unwonted supply of blood was drawn
to his brain, that surprised organ proved its gratitude by giv¬
ing birth to a timely and sensible idea. With an unaccus¬
tomed resourcefulness, by cutting off the supply of light at
the switch, he put the entire ward in darkness. Secretly I
admired the stratagem, but my words on that occasion

92

A MIND THAT FOUND ITSELF

probably conveyed no idea of the approbation that lurked
within me.

I then went to bed, but not to sleep. The ecstasy of ela¬
tion made each conscious hour one of rapturous happiness,
and my memory knows no day of brighter sunlight than
those nights. The flood gates of thought were wide open.
So jealous of each other were the thoughts that they seemed
to stumble over one another in their mad rush to present
themselves to my re-enthroned ego.

I naturally craved companionship, but there were not
many patients to whom I cared to talk. I did, however,
greatly desire to engage the assistant physician in conversa¬
tion, as he was a man of some education and familiar with
the history of my case. It will be recalled that the assistant
physician at the sanatorium subjected me to mechanical
restraint on the plea of protecting me against myself, and
later, with disgusting brutality, assaulted me. The assist¬
ant physician who now had me in charge acted with a like
inconsistency. When my vocal cords were bound as with a
chain, by delusions, he had tried to induce me to speak.
Now, when I was at last willing to talk, he would scarcely
condescend to listen. What seemed to me his studied and
ill-disguised avoidance only served to whet my desire to
detain him whenever possible. Of course my flow of words
was interminable. To listen to all of it would have been
unbearable, - and, indeed, physically impossible for a doc¬
tor with duties to other patients as well as to myself. Y et a
physician genuinely interested in his work would, as I
continue to think, have been glad to observe my case more
closely than this one did — for scientific if not humanitarian
reasons. That I do him no injustice I am led to believe
by his subsequent conduct. He was content to act as a
sort of monitor, to which role he added that of despot

A MIND THAT FOUND ITSELF

93

when anything arose to interrupt the even tenor of his almost
automatic supervision.

It was about the second week that my investigating and
reformatory turn of mind became acute. The ward in
which I was confined was well furnished and as home-like
as such a place could be, though in justice to my own home
I must observe that the resemblance was not great. About
the so-called “violent” ward I had far less favorable ideas.
Though I had not been subjected to physical abuse dur¬
ing the first fourteen months of my stay in this institution,
I had seen unnecessary and oftentimes brutal force used by
the attendants in the restraint of several so-called “violent”
patients, who, upon their arrival, had been placed in the ward
where I was. I had also heard convincing rumors of rough
treatment of irresponsible patients in the violent ward. Of
course the rules of the institution forbade such treatment (as
the rules of all such institutions invariably do) except on
those rare occasions when attendants are obliged to act in
self-defense.

Having a world of energy to dispense I determined to
conduct a thorough investigation of the institution. In
order that I might have proof that my intended action was
deliberate, my first move was to tell one or two fellow-patients
that I should soon transgress some rule in such a way as
to necessitate my removal to the violent ward. At first I
thought of breaking a few panes of glass; but my purpose
was accomplished in another way — and, indeed, sooner
than I had anticipated. My conservator, in my presence,
had told the assistant physician that the doctors could per¬
mit me to telephone to him whenever they should see fit. It
was rather wTith the wish to test the unfriendly physician,
than to satisfy any desire to speak with my conservator, that
one morning I asked permission to call the latter up on the

94

A MIND THAT FOUND ITSELF

telephone. That very morning I had received a letter from
him. This the doctor knew, for I showed him the letter —
but not its contents. It was on the letter that I based my
pretext, though it did not even intimate that my brother
wished to speak to me. The doctor, however, had no way
of knowing that my statement was not true. To deny my
request was simply one of his ill-advised whims, and his re¬
fusal was given with customary curtness and contempt. I
met his refusal in kind, and presented him with a critique
of his character couched in my tersest English.

Said he, “Unless you stop talking in that way I shall have
you transferred to the Fourth Ward.” (The Fourth was
the “violent” ward.)

“Put me where you please,” was my reply. “I’U Put
you in the gutter before I get through with you.”

With that the doctor made good his threat, and the at¬
tendant escorted me to the violent ward — a willing, in
fact, eager prisoner.

The ward in which I was now placed (Saturday, Septem¬
ber 13th, 1902) was furnished in the plainest manner. The
floors were of hard wood and the walls were bare. Except
when at meals or out of doors taking their accustomed exer¬
cise, the patients usually sat together in one large room. In
this, only heavy benches were used to sit upon. Such tempt¬
ing weapons as chairs were deemed inexpedient. It was
thought that in the hands of violent patients they might be¬
come a menace to the attendants and to other patients. In
the dining-room, however, wooden chairs of a substantia
type were allowed, for patients seldom run amuck at meal
time. Nevertheless, one of the chairs in that room soon
acquired a history, part of which must be related.

As my banishment had come about on short notice I had
failed to provide myself with many things I could have de-

A MIND THAT FOUND ITSELF

95

sired. My first request was that I be supplied with station¬
ery. The attendants, acting no doubt on the doctor’s orders,
refused to grant my request; nor would they give me a lead
pencil — which, luckily, I did not need, for I happened to
be already possessed of one. Despite their refusal I man¬
aged to get some scraps of paper, on which I was soon busily
engaged in writing notes to those in authority. Some of
these (as I learned later) were delivered, but no attention
was paid to them. No doctor came near me until evening,
when the one who had banished me made his regular round
of inspection. When he appeared the interrupted conversa¬
tion of the morning was resumed — that is, by me, — and
in a similar strain. I again asked leave to telephone my
conservator. I knew that on Sunday I could not make con¬
nections, so I asked for permission to telephone on Mon¬
day. The doctor again refused, and I, of course, told him
what I thought of him.

My imprisonment pleased me. I was where I most wished
to be, and I busied myself investigating conditions and re¬
cording mental notes. As the assistant physician could
grant favors to the attendants, and had authority either to
retain or discharge them, they did his bidding and continued
to refuse most of my requests. In spite of their unfriendly
attitude, however, I did manage to persuade the supervisor
to deliver a note to the steward. In it I asked him to come
at once, as I wished to talk with him. The steward, whom
I looked upon as a friend, returned no answer and made no
visit. I supposed he, too, had purposely ignored me. As
I learned afterwards, both he and the superintendent were
absent, else perhaps I should have been treated in a less
high-handed manner by the assistant physician.

The next morning, after a renewal of my request and a
repeated refusal, I asked the doctor to send me the “ Book

A MIND THAT FOUND ITSELF

96

of Psalms” which I had had in my former room. With this
request he complied, believing, perhaps, that some religion
would at least do me no harm. I probably read my favorite
psalm, the forty- fifth; but most of my time I spent writing
on the fly-leaves psalms of my own. And if the value of a
psalm is to be measured by the intensity of feeling por¬
trayed, my compositions of that day rightly belonged beside
the writings of David. My psalms were indited to those
in authority at the hospital, and later in the day the super¬
vigor — who proved himself a friend on many occasions

took the book to headquarters.

The assistant physician, who had mistaken my malevolent
tongue for a violent mind, had placed me in an exile which
precluded my attendance upon the service which was held
in the chapel that Sunday afternoon. Time which might
better have been spent in church I therefore spent in per¬
fecting a somewhat ingenious scheme for getting in touch
with the steward. That evening when the doctor again ap¬
peared I approached him in a friendly way and politely
repeated my request. He again refused to grant it. W ith
an air of resignation I said, “Well, as it seems useless to
argue the point with you, and as the notes sent to others
have thus far been ignored, I should like, with your kind
permission, to kick a hole in your damned old building and
to-morrow present myself to the steward in his office.

“Kick away!” said he with a sneer. He then entered an
adjoining ward, where he remained for about ten minutes.

If you will draw in your mind, or on paper, a letter “L,
and let the upright part represent a room forty feet in length,
and the horizontal part one of twenty, and if you will then
picture me as standing in a doorway at the intersection of
these two lines, and the doctor behind another door at the
top of the perpendicular, forty feet away, you will have rep-

A MIND THAT FOUND ITSELF

97

resented graphically the opposing armies just prior to the
first real assault in what proved to be a siege of seven weeks.

The moment the doctor re-entered the ward, as he had to
do to return to the office, I disappeared through my door —
into the dining-room. I then walked the length of this room
and picked up one of the heavy wooden chairs, selected for
the purpose in view while the doctor and his tame charges
were at church. Using the chair as a battering-ram, without
malice — joy being in my heart — I deliberately thrust two
of its legs through an upper and a lower pane of a four-
paned plate glass window. The only miscalculation I made
was in failing to place myself directly in front of that
window, and at a proper distance, so that I might have
broken every one of the four panes. This was a source of
regret to me, and well it might have been so, for I am loath
to leave a well thought-out piece of work unfinished.

The crash of shattered and falling glass startled every one
but me. Particularly did it frighten one patient who hap¬
pened to be in the dining-room at the time. He fled. The
doctor and the attendant who were in the next room could
not see me, or know what the trouble was; but they lost no
time in finding out. Within two or three seconds they ap¬
peared, in a state of great excitement. Like the proverbial
cold-blooded murderer who stands over his victim, weapon
in hand, calmly awaiting arrest, I stood my ground, and,
with a fair degree of poise, awaited the onrush of doctor and
attendant. These soon had me in hand. Each taking an
arm they marched me to my room. This consumed not
more than half a minute, but the time was not so short as
to prevent my delivering myself of one more thumb-nail
characterization of the doctor. My inability to recall that
delineation, verbatim, entails no loss on literature, for, I

fear, my words approached an unprintable perfection. But
8

98

A MIND THAT FOUND ITSELF

one remark made as the doctor seized hold of me was apt,
though not impromptu. I had framed the sally several
hours earlier. “Well, doctor, knowing you to be a truthful
man, I just took you at your word,” said I.

Senseless as this act of mine appears it was, like so many
acts of the insane, the result of logical thinking. Indeed,
logical thinking among the insane is common, rather than
rare. But the logical faculty in an insane person is usu¬
ally of slight advantage to him, for he reasons either from
a false premise, or reasoning correctly he betrays his insane
condition when he attempts to apply his logic to a given
situation. An illuminating example of an insane appli¬
cation of sound logic is afforded by the incident I am now
discussing. The steward had entire charge of the building
and ordered all necessary repairs. It was he whom I de¬
sired above all others to see, and I reasoned that the brea -
ina of several dollars’ worth of plate glass (for which,
later, to my surprise, I had to pay) would compel his atten¬
tion on grounds of economy, if not those of the fnen y
interest which I now believed he had abandoned. Bar >
the next morning, as I had hoped, the steward appeared
He approached me in a friendly way (as had been is won
and I met him in a like manner. Said he, good-naturedly,
“I wish you would leave a little bit of the building.

“I will leave it all, and gladly, if you will pay some atten¬
tion to my messages,” said X. ,

“Had I not been out of town,” said he, “I would have
come to see you sooner.” And this honest excuse I behoved

and accepted. . . . . . .

I made known to the steward the assistant physician

havior in balking my desire to telephone my conservator.
He agreed to place the matter before the superintendent,
who had that morning returned. As proof of gratiuit o,

A MIND THAT FOUND ITSELF

99

I promised to suspend hostilities until I had had a talk
with the superintendent. I made it quite plain, however,
that should he fail to keep his word, I would further facili¬
tate the ventilation of the violent ward — not a polite thing
to say, but my faith in mankind was not yet wholly re¬
stored.

XIV

A few hours later, without having witnessed anything of
particular significance, except as it befell myself, I was trans¬
ferred to my old ward. The superintendent, who had or¬
dered this rehabilitation, soon appeared, and he and I had a
satisfactory talk. He gave me to understand that he him¬
self would look after my case, as he realized that his. assist¬
ant lacked the requisite tact and judgment to cope with one
of my temperament - and with that, my desire to telephone

my conservator vanished. _

Now no physician would like to have his wings clippe y
an insane patient, even indirectly, and without doubt I t
man’s pride was piqued as his incompetence was thus made
patent. Thereafter when he passed through the waid he
and I had frequent tilts. Not only did 1 lose no opportunity
to belittle him in the presence of attendants and patients, but
I even created such opportunities; so that before long ic
studiously avoided me whenever possible. But it seldom
was possible. My chief amusement consisted in what were
really one-sided interviews with him. Occasionally he was
so unwise as to stand his ground for several minutes, and
his arguments on such occasions served only to keep my tem¬
per at a vituperative heat. If there were any epithets which
1 failed to apply to him during the succeeding weeks of my
association with him they must have been coined since. 1
am no candidate for the reputation which attaches to mean
tongues; but I wish to give some slight excuse for the hateful
way in which this man treated me when I finally fell into

oo

A MIND THAT FOUND ITSELF

IOI

his power. The fact is that the uncanny admixture of san¬
ity displayed by me, despite my insane condition, was some¬
thing this doctor could not comprehend. Remarks of mine,
therefore, which should have been discounted or ignored,
rankled in his breast as the insults of a sane and free man
would have done. No doubt a rare degree of tact was what
was required for the proper and continued control of a
patient of my temperatment. Yet I am sure a judicious
granting of requests, or a helpful refusal, would have
contributed to an earlier recovery and insured a less stormy
period of convalesence. For a mind as active as mine to
be contented for long was out of the question; yet I know
that the blunt and indiscriminate refusal of most of my re¬
quests prolonged my period of mental excitement; whereas,
fair treatment would have restored me to health, freedom,
and society several months earlier. The loss of time is of
small moment, but the risk of irreparable injury which
I was forced to assume is not to be lightly regarded. That
some curable cases of insanity have been made chronic
by just such treatment as I was fortunate enough to survive
is an indisputable fact, — direct proof whereof can never be
offered by these hapless ones, for they are now in their graves
— living graves, some of them.

When my period of depression gave way to one of elation,
an ultimate, if temporary recovery at least was assured.
What followed was a period of convalescence, and the doc¬
tors knew that the return of my brain to its normal condition
would be only a question of time, — though they could not
predict whether normality would long continue, for cycles
of depression and elation tend to recur in a brain that has
once been so affected. Surely I was entitled to the sanest
of treatment from the very moment the state of comparative
sanity manifested itself. Instead, I was soon subjected to

102

A MIND THAT FOUND ITSELF

treatment so brutal that I might not have survived it had
I not been blessed with a strong constitution and a virile

hope.

After my return to my old ward I remained there for a
period of three weeks. At that time I was a very self-cen¬
tered individual. My large and varied assortment of delu¬
sions of grandeur made everything seem possible. There
were few problems I hesitated to attack. With sufficient
provocation I even attacked attendants — problems in
themselves; but such fights as I subsequently engaged in
were fights, either for my own rights or the rights of
others. Though for a while I got along fairly well with
the attendants and as well as could be expected with the
assistant physician, it soon became evident that these men
felt that to know me more was to love me less. Owing
to their lack of capacity for the work required of them,

I was able to cause them endless annoyance. Many
times a day I would instruct the attendants what to do
and what not to do, and tell them what I should do
if my requests, suggestions, or orders were not immedi¬
ately complied with. For over one year the attendants
had seen me in a passive, almost speechless condition, and
they were, therefore, unable to understand my unwonted
aggressions. The threat that I would chastise them for any
disobedience of my orders they looked upon as a huge joke.
So it was, until one day I incontinently cracked that joke

against the head of one of them.

It began in this wise: Early in October a man was com¬
mitted to my ward whose abnormality for the most part con¬
sisted of an inordinate thirst for liquor. He did not appear
to me to be really insane, nor, according to report, had he
ever been so, except as thousands of free men are who have
poisoned their systems with strong drink. He was over

A MIND THAT FOUND ITSELF

103

fifty years of age, well educated, traveled, refined and of an
artistic temperament. Congenial companions were scarce
where I was, and he and I were soon drawn together in
friendship. This man had been trapped into the institu¬
tion by the subterfuge of relatives. As is common in such
cases many “white” lies had been resorted to in order to
save trouble for all concerned, — that is, all except the pa¬
tient. To be taken without notice from one’s home and
by a deceitful, though, under the circumstances, perhaps
justifiable strategy, placed in a ward with fifteen other men,
all exhibiting insanity in varying degrees, is as heartbreak¬
ing an ordeal as one can well imagine. Yet such was this
man’s experience. A free man one day, he found himself
deprived of his liberty the next, and branded with what he
at the time considered an unbearable disgrace. In justice
to the relatives of this man, however, it is but fair to credit
them with good intentions. They simply erred through ig¬
norance. Like ninety-nine out of a hundred persons so
situated, they did not know that it is not only safe, but ad¬
visable, to tell the afflicted one the truth, and nothing but
the truth — after his mental condition has been passed upon
by competent authorities and arrangements have been made
for his transfer to a public or private hospital. This point
I have discussed with physicians who have had placed under
their care hundreds of insane persons. Their advice may
be summed up as follows: After the relatives of an insane
person, or of a person threatened with insanity, have reached
the point where commitment of the patient has become in¬
evitable, let them act with decision, tact, and honesty. First
complete the arrangements for the transfer of the patient
to the hospital; then shortly before the transfer is to be made,
tell the patient frankly why such action has been taken or
tell him earlier, provided he be kept constantly under the

104

A MIND THAT FOUND ITSELF

care of a nurse — this to guard against any overt act induced
by that innate and sometimes overpowering dread of con¬
finement in a hospital for the insane.1 Emphasize the fact
that a mental disorder cannot be treated properly at home,
and that the patient will stand a better chance for recovery
in an institution than out of one, — which is true. Assure
the patient that he will be visited often by relatives and
friends, and impress upon him that his every interest will
be safeguarded. Then keep such promises to the letter.
Experience teaches that a patient who is treated honestly
from the beginning usually enters a hospital with compar¬
atively slight reluctance. Further, he is quick to appreciate
the advantages of hospital treatment, — indeed, he frequently
appreciates its benefits much sooner than those who effected
his commitment. Thus, by a firm, tactful, honest method
of procedure, a patient’s confidence in his relatives, friends
and the hospital authorities is at once established and easily
maintained, with incalculable benefit to all; whereas, on the
other hand, subterfuge and “white” lies which are so
often black lies, undermine the confidence of the patient,
make him unhappy, delay his recovery, and seriously ham¬
per the hospital officials in their appointed work.

Mr. Blank (as I shall call him) was completely unnerved.

i As laws regarding commitment are not uniform throughout the coun¬
try, it would be necessary in some States to tell the patient, earlier than is
here suggested, of his impending transfer to a hospital. Thus do imper¬
fect statutes help to make worse a situation already distressing. Another
source of trouble is an ignorant handling of the patient, on his way to a hos¬
pital. Trained attendants should be called in at such a time, as is required
by law in some States. A general adoption of this law will put a stop to t ic
humiliating, oftentimes cruel, and invariably unnecessary hand-cuffing and
binding of insane persons while being transferred to an institution
seems fair that nurses rather than ignorant, and perhaps unfeeling, officers
of the law, should be placed in charge of a person who need plead guilty o
no charge other than that of being in ill-health.

A MIND THAT FOUND ITSELF

!°5

As he was a stranger in what I well knew was a strange
world I took him under my protecting and commodious
wing. I did all I could to cheer him up, and tried to secure
for him from the attendants that consideration which I
deemed indispensable to his well-being. Patients in his
condition had never been forced, when taking their exercise,
to walk about the grounds with the other patients. At no
time during the preceding fourteen months had I seen a
newly-committed patient forced to exercise against his will.
One who objected was invariably left in the ward, or his
refusal reported to the doctor before further steps were
resorted to. No sane person need stretch his imagination
in order to realize how humiliating it would be for this man
to walk with a crowd which greatly resembled a “chain-
gang.” Two by two, guarded by an attendant — usually
two attendants these hostages of misfortune get the only
long walks their restricted liberty allows them. After the
one or two occasions when this man did walk with the gang
I was impressed with the not wholly unreasonable thought
that the physical exercise in no way compensated for the
mental distress which the sense of humiliation and disgrace
caused him to suffer. It was therefore delightfully easy for
me to interfere in his behalf j and when he came to my room,
wrought up over the prospect of another such humiliation
and weeping bitterly, I assured him that he should take his
exercise that day when I did. My first move to accomplish
the desired result was to approach, in a friendly way, the
attendant in charge, and ask him to permit my new friend to
walk about the grounds with me when next I went. He
said he would do nothing of the kind — that he intended to
take this man when he took the others. Said I, “ For over
a year I have been in this ward and so have you, and I have

106 A MIND THAT FOUND ITSELF

never yet seen a man in Mr. Blank’s condition forced to go
out of doors.”

“It makes no difference whether you have or not,” said
the attendant, “he’s going.”

“Will you ask the doctor whether Mr. Blank can or can¬
not walk about the grounds with my special attendant when
I go?”

“No, I won’t. Furthermore, it’s none of your business.”

“If you resort to physical force and attempt to take Mr.
Blank with the other patients, you’ll wish you hadn’t,”
said I, and I walked away.

At this threat the attendant scornfully laughed. To him
it meant nothing. He believed I could fight only with my
tongue, and I confess that I myself was in doubt as to my
power of fighting otherwise.

Returning to my room where Mr. Blank was in waiting,
I supported his drooping courage and again assured him
that he should be spared the dreaded ordeal. I ordered
him to go to a certain room at the farther end of the hall and
there await developments — so that, should there be a fight,
the line of battle might be a long one. He obeyed. In a
minute or two the attendant was headed for that room. I
followed closely at his heels, still threatening to attack him
if he dared so much as lay a finger on my friend. Though
I was not then aware of it, I was followed by another pa¬
tient, a man, who, though insane, had his lucid intervals and
always a loyal heart. He seemed to realize that trouble
was impending and that very likely I should need help.
Once in the room the war of words was renewed, my sensi¬
tive and unnerved friend standing by and looking anxiously
on.

“I warn you once more,” said I, to the attendant, “if you
touch Mr. Blank I’ll punch you so hard you’ll wish you

A MIND THAT FOUND ITSELF

107

hadn’t.” The attendant’s answer was an immediate at¬
tempt to eject Mr. Blank from the room by force. Nothing
could be more automatic than my action at that time; —
indeed, to this day I do not remember performing the act
itself. What I remember is the determination to perform
it and the subsequent evidence of its having been performed.
I remember every part of the encounter except the one in¬
stant devoted to the execution of my predetermined coup de
main. At all events I had already made up my mind to do
a certain thing if the attendant did a certain thing. He did
the one and I did the other. Almost before he had touched
Mr. Blank’s person my right fist struck him with great force
in, on, or about the left eye. It was then that I became the
object of the attendant’s attention — but not his undivided
attention — for, as he was choking me, my unsuspected ally
stepped up and paid the attendant a sincere compliment by
likewise choking him. In the scuffle I was forced to the
floor. The attendant had a hand upon my throat. My
ward-mate had both hands upon the attendant’s throat.
Thus was formed a chain with a weak, if not a missing, link
in the middle. Picture if you will an insane man being
choked by a supposedly sane man, and he in turn being
choked by a temporarily sane insane friend of the assaulted
one, and you will have Nemesis more nearly in a nutshell
than any mere rhetorician has yet been able to put her.

That I was well choked is proved by the fact that my
throat bore the crescent-shaped mark of my assailant’s
thumb nail. And I am inclined to believe that my rescuer,
who was a very powerful man, made a decided impression
on the attendant’s throat. Had not the superintendent op¬
portunely appeared at that moment the attendant might
soon have lapsed into unconsciousness, for I am sure my
ally would never have released him until he should have

io8 A MIND THAT FOUND ITSELF

released me. The moment the attendant with his one good
eye caught sight of the superintendent the scrimmage ended.
This was but natural, for it is an offense against the code
of honor generally obtaining among attendants that one
should so far forget himself as to abuse patients in the pres¬
ence of sane and competent witnesses.

The choking which I had just received only served to
limber my vocal cords. I told the doctor all about the pre¬
liminary verbal skirmish and the necdlessness of the fight.
The superintendent had graduated at Yale over fifty years
prior to my own graduation, and because of our common
interests and his consummate tact we got along well together.
But his friendly interest did not keep him from speaking his
mind upon occasions, as his words at this time proved. Y ou
don’t know how it grieves me to see you — a Yale man

act so like a rowdy,” said he.

“If fighting for the rights of a much older man, unable to
protect his own interests, is the act of a rowdy, I’m quite
willing to be thought one,” was my reply.

Need I add that the attendant did not take Mr. Blank
for a walk that morning? Nor, so far as I know, was the
latter ever forced again to take his exercise against his will.

I have devoted much space to the foregoing incident be¬
cause it represents fairly a majority of the assaults nov
committed in our asylums. Had the attendant possessed
and exercised tact, there would have been no needless as¬
sault committed that day. In my opinion the number of
fights or assaults caused by insane patients running amuck
is smaller, relatively, than the number of fights that would
naturally occur among a given number of schoolboys, full
of animal spirits. Nine out of ten of the hundreds of as-

A MIND THAT FOUND ITSELF

109

saults which occur annually in our hospitals and asylums
are the fault of the attendants rather than of their charges.
It is therefore evident that the solution of the problem of
eliminating brutality centers in the attendants, the majority
of whom to-day are deplorably incompetent. In fact the
only attendants who are not likely at times to commit out¬
rages are those who at heart are believers in “Non-
Restraint;” — and that more of them do not use that
humane method of treatment is the fault of the doctors
in charge.

XV

The superintendent now realized that I was altogether
too energetic a humanitarian to remain in a ward with so
many other patients. My actions had a demoralizing effect
upon them; so I was forthwith transferred to a private room,
one of two situated in a small one-story annex. These new
quarters were rather attractive, and not unlike a conven¬
tional bachelor apartment.

As there was no one here with whom I could interfere I
got along without making any disturbance — that is, so
long as I had a certain special attendant, a man suited to my
temperament. He who was now placed over me understood
human nature and could recognize it even in an insane man.
He never resorted to force if argument failed to move me;
and trifling transgressions, which would have led to a fight
had he behaved like a typical attendant, he either ignored
or privately reported to the doctor. This competent attend¬
ant, whom I liked, could and did control me with ease. As
it is in the world at large, so in asylums likes and dislikes
are usually mutual. Accordingly, for the whole period of
my intense excitement there were certain doctors and at¬
tendants who could control me, and certain other doctors
and attendants whose presence threw me into a state border¬
ing on rage, and frequently into passions which led to dis¬
tressing results. To place over me those I liked, rather than
attempt to make me adjust my unruly personality to those
I hated, would have cost attention and perhaps inconven¬
ience. But would not the reward have been worth the pains ?

I IO

A MIND THAT FOUND ITSELF

in

And if hospitals exist for the purpose of restoring patients
to health, was I not of right entitled to all such benefits ?

Good attendants seldom stay long at their work, for their
rewards are insignificant, if not insulting. Unfortunately
for me, my good attendant soon left the institution to accept
a more attractive business offer. He left without even a
good-by to me. Nothing proves more conclusively how
important to me would have been his retention than this
abrupt leave-taking which the doctor had evidently ordered,
thinking perhaps that the prospect of a change of attendants
would excite me. However, I caused no trouble when the
substitution was made, though I did dislike the idea of hav¬
ing placed over me a man with whom I had previously had
misunderstandings. He was about my own age and it was by
no means so easy to take orders from him as it had been to
obey his immediate predecessor who was considerably older
than myself. Then, too, this young attendant disliked me
because of the many disagreeable things I had said to him
while I was confined in a general ward. He weighed about
one hundred ninety pounds to my one hundred thirty, and
had evidently been delegated to attend me because of his
great physical strength. But I am inclined to think that a
choice based on mental rather than physical considerations
would have been wiser. The superintendent, because of
his advanced age and ill health, had been obliged again to
place my case in the hands of the assistant physician, and
the latter gave this new attendant certain orders. What I
was to be permitted to do, and what not, was carefully
specified. These orders, many of them unreasonable, were
carried out to the letter. For this I cannot justly blame the
attendant. The doctor had deprived him of the right to
exercise what judgment he had.

At this period I required but little sleep. I usually spent

1 1 2

A MIND THAT FOUND ITSELF

part of the night drawing; for it was in September, 1902,
while I was at the height of my wave of self-centered con¬
fidence, that a friend who came to see me had given me a
copy of Life. And as I had already decided in my own
mind that I was destined to become a writer of books or
at least of one book — I thought I might as well be an artist,
too, and illustrate my own productions. In school I had
never cared for drawing; nor at college, either, where, at
the Yale Art School, I took a compulsory and distasteful
course in that subject. But now my awakened artistic im¬
pulse was irresistible. My first self-imposed lesson was a
free-hand copy of the design on the cover of Life, includ¬
ing the illustration. Considering the circumstances, that
first drawing was creditable, though I cannot now prove the
assertion; for inconsiderate attendants destroyed it, with
many more of my drawings and manuscripts. From the
very moment I completed that first drawing, honors were
divided between my literary and artistic impulses; and a
letter which, in due time, I was impelled to write to the Gov¬
ernor of the State incorporated art with literature. I wrote
and read several hours a day and I spent as many more,
drawing. But the assistant physician, instead of making it
easy for me to rid myself of an excess of energy along literary
and artistic fines, balked me at every turn, and seemed to
delight in displaying as little interest as possible in my newly
awakened ambitions. So that at a time when everything
should have been done to calm my abnormally acti\c mind,
a studied indifference and failure to protect my interests
kept me in a state of constant exasperation.

But circumstances now arose which brought about the
untimely stilling — I might better say strangulation — of
my artistic impulses. The doctors were led unwisely, I
believe, considering their methods and the hospital s equip-

A MIND THAT FOUND ITSELF

113

ment — to decide that absolute seclusion was the only thing
that would ease my over-active brain. In consequence, all
writing and drawing materials and all books were taken from
me. And from October 18th until the first of the following
January, except for one short fortnight, my brain was left
again to all but beat itself into an insane condition, either
against itself, or the bare walls and floors of the small, barred
rooms in which I was next confined — hardly better than
cells in a State’s prison and in some instances far worse.

A corn-cob was the determining factor at this crisis. See¬
ing in myself an embryonic Raphael I had a habit of
preserving all kinds of odds and ends as souvenirs of my
development. These, I believed, sanctified by my Midas-like
touch, would one day be of great value. If the public can
tolerate, as it does, thousands of souvenir hunters, surely an
inmate of an asylum should be indulged in the whim for
collecting such souvenirs as come within his reach. Among
the odds and ends which I had gathered were several corn¬
cobs. These I intended to gild and make useful by attach¬
ing to them small thermometers. If they seemed valuable
to me at the time, that fact in itself should have been reason
enough for permitting me to retain them. But, on the morn¬
ing of October 18th, my athletic attendant, finding them,
forthwith informed me that he should throw them away.

I as promptly informed him that any such action on his
part would lead to a fight. And so it did.1 * * * * * * * 9

1 Though I admit that the impulse to collect souvenirs must be held in

check, lest a patient’s room become a sort of junk-shop, I will not admit

that the “ souvenir habit” can best be cured by a resort to force — and abu¬

sive language. A tactful appeal to a patient’s sense of right and justice will

insariably accomplish a better and more lasting result. Witness the case

of the attendant whose insane charge had jumped into a deep river with the

mad desire to drown himself. “If you don’t come back here I’ll lose my

job!” shouted the attendant in desperation. The prospective suicide heard

9

A MIND THAT FOUND ITSELF

114

When this fight began there were two attendants at hand.

I fought them both to a standstill, and told them I should
continue to fight until the assistant physician came to the
ward. Thereupon, my special attendant, realizing that I
meant what I said, held me while the other went for assist¬
ance. He soon returned, not with the assistant physician,
but with a third attendant, and the fight was renewed. The
one who had acted as messenger, being of finer fiber than
the other two, stood at a safe distance. It was of course
against the rules of the institution for an attendant to strike
a patient, and, as I was sane enough to report with a fair
chance of belief any forbidden blows, each captor had to
content himself with holding me by an arm and attempting
to choke me into submission. However, I was able to pre¬
vent them from getting a good grip on my throat, and for
almost ten minutes I continued to fight, telling them all the
time that I would not desist until a doctor should come.
An assistant physician, but not the one in charge of my
case, finally appeared. He ordered the attendants to place
me in the “violent ward,” which adjoined the private apart¬
ment I was then occupying, and they lost no time in lock¬
ing me in a small room in that ward.

This first fight of the day occurred about 8 a.m. — a fact
which should be noted, for October 18th, 1902, was about
the busiest day of my life. Three fights between sunrise
and sunset, and two other incidents not less full of action,
and one of them full of torture, give that day a distinctive

character.

Friends have said to me: “Well, what is to be done
with an insane man when he runs amuck?” The best

the appeal, swam ashore, was saved, and to-day enjoys
The truth of this incident is vouched for by Dr. Adolf

health and freedom.
Meyer, of Baltimore.

A MIND THAT FOUND ITSELF

115

answer I can make is: “Do nothing to make him run
amuck.”

A man in the condition in which I was during the period
of my elation is a spoiled child. If he wants a thing, harm¬
less to himself and to others, he should have it. A hospital
for the insane must answer many of the purposes of a kin¬
dergarten and, at times, may well be turned into one. The
greater initial expenditure entailed in the individual treat¬
ment of a case would be offset by the more rapid recovery
and earlier discharge of the patient. While I was on the
rampage, not more than four or five others under the care
of the assistant physician required especial attention. But I
required it, and, realizing this, I did my best to get it.
Certain psychiatrists support me in the opinion that
had I had an attendant with the wisdom and ability to
humor me and permit me to keep my priceless corn-cobs,
the fight in question, and the worse events that followed,
would not have occurred — not that day, nor ever, I believe,
had I at all times been properly treated by those in charge
of me.

So again I found myself in the violent ward — but this
time not because of any desire to investigate it. Art and
literature being now more engrossing than my plans for re¬
form, I became, in truth, an unwilling occupant of a room
in a ward devoid of even a suggestion of the aesthetic. The
room itself was clean, and under other circumstances might
have been cheerful. It was twelve feet long, seven feet
wide, and twelve high. A cluster of incandescent lights,
enclosed in a semi-spherical glass globe, depended from the
ceiling. The walls were bare and plainly wainscotted,
and one large window, barred without, gave light. At
one side of the door was an opening a foot square with a

Ii6 A MIND THAT FOUND ITSELF

door of its own which could be opened only from without,
and through which food could be passed to a supposedly
dangerous patient. Aside from an iron cot bed, screwed
to the floor, the room had no furniture.

The attendant, before locking me in, searched me and took
from me several lead pencils; but the stub of one escaped his
vigilance. Naturally, to be taken from a handsomely fur¬
nished apartment and thrust into such a bare and unattrac¬
tive room as this, caused my already heated blood to
approach the boiling point. Consequently, my first thought
was to send a note to the physician who regularly had
charge of my case, requesting him to visit me as soon as he
should arrive — and I have every reason to believe that the
note was delivered. Whether or not this was so, a report
of the morning’s fight and my transfer must have reached
him by some one of the several witnesses. While waiting
for an answer, I busied myself writing, and as I had no
better supply of stationery I wrote on the walls. Begin¬
ning as high at I could reach I wrote in columns, each about
three feet wide. Soon the pencil became dull. But dull
pencils are easily sharpened on the whetstone of wit. Stifling
acquired traits, I permitted myself to revert momentarily to
a primitive expedient. I gnawed the wood quite from the
pencil, leaving only the graphite core. With a bit of graphite
a hand guided by the unerring insolence of elation may ar¬
tistically damn all men and things. That I am inclined to
believe I did ; and I question whether Raphael or Michael
Angelo — upon whom I then looked as mere predecessors
— ever put more feeling per square foot into their mural
masterpieces.

Every little while, as if to punctuate my composition, and
in a vain endeavor to get attention, I kicked the door vigor¬
ously. Knowing the history of my case, the assistant physi-

A MIND THAT FOUND ITSELF 117

cian when he learned of my transfer should have made a
special visit. But this he neglected to do. Not until eleven
o’clock, on his regular round of inspection, did he come near
me. As a result I was left for three hours to thrash around
that room and work myself into a state of desperate rage. I
made up my mind to compel attention. A month earlier,
shattered glass had enabled me to accomplish a certain sane
purpose. Again this day it served me. The opalescent
globe at the ceiling seemed to be the most vulnerable point
for attack. How to reach and smash it was the next ques¬
tion and soon answered. Taking off my shoes I threw
one with great force at my glass target and succeeded in
striking it a destructive blow.

When attendants’ ears become as nicely attuned to the
suppliant cries of neglected patients as they now are to the
summoning sound of breaking glass, many of the abuses of
which I complain will cease forever to be heard of. The
attendants charged upon my room. Their entrance was
momentarily delayed by the door which stuck fast. I was
standing near it, and when it gave way its edge struck me on
the forehead with force enough to have fractured my skull
had it struck a weaker part. The attendants were unable
to see me, and for this hurt no blame attached to them, ex¬
cept in so far as it was the indirect result of their continued
neglect of me.

Once in the room the two attendants threw me on the bed
and choked me so severely that I could feel my eyes start¬
ing from their sockets. When attendants choke patients
they do so in a bungling manner — even those who have
conducted the brutal operation often enough to have mas¬
tered the technique of it. As it was, a clumsy fellow filled
his fist with most of the muscles in my neck and then pro¬
ceeded to manipulate my throat much as one would squeeze

„8 A MIND THAT FOUND ITSELF

a sponge. The attendants then put the room in order; re¬
moved the glass — that is, all except one small and apparently
innocent, but as the event proved well-nigh fatal, piece, —
took my shoes and again locked me in my room not for¬
getting, however, to curse me well for making them work
for their living.

When the assistant physician finally appeared I met him
with a blast of invective which, in view of the events which
quickly followed, must have blown out whatever spark of
kindly feeling toward me he may have ever entertained. I
demanded that he permit me to send word to my conserva¬
tor asking him to come at once and look after my interests,
for I was being unfairly treated. I also demanded that he
request the superintendent to visit me at once, as I intended
to have nothing more to do with assistant physicians or at¬
tendants who were neglecting and abusing me. He yielded
to neither demand.

The bit of glass, which the attendants had overlooked,
was as large as my thumb nail. If I remember rightly it
was not a part of the broken globe. It was a piece that had
probably been hidden by a former occupant, in a comer of
the square opening at the side of the door. At all events,
if the pen is the tongue of a ready writer, so may a piece of
glass be, under given conditions. As the thought I had in
mind seemed an immortal one I decided to etch, rather than
write with fugitive graphite. On the topmost panel of the
door, which a few minutes before had dealt me so vicious a
blow, I scratched a seven-word sentiment - sincere, if not
classic: “God bless our Home, which is Hell.”

The violent exercise of the morning had given me a good
appetite and I ate my dinner with relish, though with some
difficulty, for the choking had lamed my throat. On serving
this dinner the attendants again left me to my own devices.

A MIND THAT FOUND ITSELF

119

The early part of the afternoon I spent in vain endeavors to
induce them to take notes to the superintendent and his
assistant. They continued to ignore me. By sundown the
furious excitement of the morning had given place to what
might be called a deliberative excitement, which, if anything,
was more effective. It was but a few days earlier that I had
discussed my case with the assistant physician and told him
all about the suicidal impulse which had been so strong
during my entire period of depression. I now reasoned that
a seeming attempt at suicide, a “fake” suicide, would frighten
the attendants into calling this doctor whose presence I now
desired — and desired the more because of his persistent
indifference. No man that ever lived loved life more than
I did on that day, and my mock tragedy which I successfully
played about dusk was, I believe, as good a farce as was ever
perpetrated. If I had any one ambition it was to live long
enough to regain my freedom and put behind iron bars this
doctor and his tools, the attendants. To compel attention
— that was my object.

At that season the sun set by half-past five and supper was
usually served about that time. So dark was my room then
that objects in it could scarcely be distinguished. About a
quarter of an hour before the attendant was due to appear
with my evening meal I made my preparations. That the
stage setting might be in keeping with the plot, I tore up
such papers as I had with me, and also destroyed other ar¬
ticles in the room — as one might in a frenzy; and to com¬
plete the illusion of desperation, deliberately broke my watch.
I then took off my suspenders, and tying one end to the head
of the bedstead made a noose of the other. This I adjusted
comfortably about my throat. At the crucial moment I
placed my pillow on the floor beside the head of the bed
and sat on it — for this was to be an easy death. I then

120

A MIND THAT FOUND ITSELF

bore just enough weight on the improvised noose to give all a
plausible look. And a last life-like (or rather death-like)
touch I added by gurgling as in infancy’s happy days.

No schoolboy ever enjoyed a prank more than I enjoyed
this one. Soon I heard the step of the attendant, bringing my
supper. When he opened the door he had no idea that any¬
thing unusual was happening within. Coming as he did
from a well lighted room into one that was dark it took him
several seconds to grasp the situation — and then he failed
really to take it in, for he at once supposed me to be in a semi¬
unconscious condition from strangulation. In a state of
great excitement this brute of the morning called to his
brute-partner and I was soon released from what was nothing
more than an amusing position, though they believed it one
of torture. The vile curses with which they had addressed
me in the morning were now silenced. They spoke kindly
and expressed regret that I should have seen fit to resort to
such an act. Their sympathy was as genuine as such men
can feel, but a poor kind at best, for it was excited by the
thought of what might be the consequences to them of their
own neglect. While this unwonted stress of emotion threat¬
ened the attendants’ peace of mind I continued to play my
part, pretending to be all but unconscious.

Shortly after thus rescuing me from a very living death,
the attendants picked me up and carried my limp body and
laughing soul to an adjoining room, where I was tenderly
placed upon a bed. I seemed gradually to revive.

“What did you do it for?” asked one of the attendants.

“What’s the use of living in a place like this, to be abused
as I’ve been to-day?” I asked. “You and the doctor ignore
me and all my requests. Even a cup of water between meals
is denied me, and other requests which you have no right
to refuse. Had I killed myself, both of you would have been

A MIND THAT FOUND ITSELF

I 2 1

discharged. And if my relatives and friends had ever found
out how you had abused and neglected me it is likely you
would have been arrested and prosecuted.”

Word had already been sent to the assistant physician.
He hurried to the ward, his almost breathless condition
showing how my farce had been mistaken for a real tragedy.
The moment he entered I abandoned the part I had been
playing.

“Now that I have you three brutes where I want you I’ll
tell you a few things you don’t know,” said I. “You prob¬
ably think I’ve just tried to kill myself. It was simply a
ruse to make you give me some attention. When I make
threats and tell you that my one object in life is to live long
enough to regain my freedom and lay bare the abuses which
abound in hospitals for the insane you simply laugh at me,
don’t you? But the fact is, that’s my ambition, and if you
knew anything at all you’d know that abuse won’t drive me
to suicide. You can continue to abuse me and deprive me
of my rights, and keep me in exile from relatives and friends,
but the time will come when I’ll make you sweat for all this.
I’ll put you in prison where you belong. Or if I fail to do
that, I can at least bring about your discharge from this in¬
stitution. What’s more, I will.”

The doctor and attendants now took my threats with
characteristic nonchalance. Such threats, often enough
heard in such places, make little or no impression, for
they are seldom made good. Most of those subjected to
abuse and neglect never regain their freedom; or, if they
do, have not an accurate enough memory, or a stout enough
heart, to support any inclination they may have to proceed
to action. When I made these threats I really wished to
put these men in prison. To-day I have no such desire,
for were they not victims of the same vicious system of

122

A MIND THAT FOUND ITSELF

treatment to which I was subjected ? In every institution
conducted on the principles of “Restraint” the very atmos¬
phere is brutalizing. Place a bludgeon in the hand of any
man, with instructions to use it when necessary, and the
gentler and more humane methods of persuasion are natu¬
rally forgotten or deliberately abandoned.

Throughout my period of elation, especially the first months
of it when I was doing the work of several normal men, I
required an increased amount of fuel to generate the abnor¬
mal energy my activity demanded. I had the characteristic
voracious appetite, and I now insisted that the attendant gi\e
me the supper which he was about to serve when he discov¬
ered me in the simulated throes of death. At first he re¬
fused, but finally relented and brought me a cup of tea and
some buttered bread. Because of the severe choking
administered earlier in the day it was with difficulty that I
swallowed any food. I had to eat slowly. The attendant,
however, ordered me to hurry and threatened otherwise to
take what little supper I had. I told him that I thought he
would not — that I was entitled to my supper and intended
to eat it with as much comfort as possible. This nettled
him, and by a sudden and unexpected move he managed to
take from me all but a crust of bread. Even that he tried
to snatch. I resisted and the third fight of the day was soon
on, — and that within five minutes of the time the doctor
had left the ward. At the time I was seated on the bed.
The attendant, true to his vicious instincts, grasped my
throat and choked me with the full power of a hand accus¬
tomed to that unmanly work. His partner, in the mean¬
time, had rendered me helpless by holding me flat on my back
while the attacking party choked me into breathless sub mis-

A MIND THAT FOUND ITSELF

123

sion. The first fight of the day was caused by a corn-cob;
this of the evening by a crust of bread. Insignificant things
— but eloquent evidence. In each instance an insane man,
conscious of his rights, was assaulted by two sane but un¬
trained and unfeeling men whose brutal methods were coun¬
tenanced by a sane physician.

Were I to close the record of events of that October day
with an account of the assault just described, few, if any,
would imagine that I had failed to mention all the abuse to
which I was that day subjected. The fact is that not the
half has been told. As the handling of me within the twenty-
four hours typifies the worst, but, nevertheless, the not un¬
usual treatment of all patients in a like condition, I feel
constrained to describe minutely the torture which was my
portion that night. I would prefer not to deal at such
length with so distressing a subject, but to yield to that
preference would not be the way of truth. There are
abuses to be corrected and they must be laid bare by one
with personal and painful knowledge of them. Non-com¬
batants may with propriety discuss the buzzing of a mos¬
quito, but the ominous sound of the bullet can best be
described by a man who has been on the firing-line.

After that supper-fight I was left alone in my room for
about an hour. Then the assistant physician, the two at¬
tendants, and a third attendant entered. One of the attend¬
ants carried a canvas contrivance known as a camisole. A
camisole is a type of strait-jacket; and a very convenient
type it is for those who resort to such methods of restraint,1

1 There are several methods of restraint in use, chief among them:
mechanical restraint” and so-called “chemical restraint.” The former con¬
sists in the use of instruments of restraint, namely, strait-jackets or cami¬
soles, “muffs,” straps, “mittens,” “restraint” or “strong” sheets, etc.,—

124

A MIND THAT FOUND ITSELF

for it enables them to deny the use of strait-jackets at all.
A strait-jacket, indeed, is not a camisole, just as electrocu¬
tion is not hanging.

When I planned my ruse of the afternoon I knew perfectly
well that I should soon find myself in a strait-jacket. The
thought rather took my fancy, for I was resolved to know
the inner workings of the violent ward ; and as my purpose in
life was eventually to bring about reform, I bore the more
willingly, sometimes even cheerfully, much of the abuse to
which I was subjected. But the fact that my transgressions
of rules were frequently deliberate in no way excuses those
in authority. For in no other respect did my acts un¬
questionably those of an insane man differ from those of
other patients, — except, perhaps, that I was able to avoid
their repetition and thus escape much of the punishment
which falls to the lot of those who know not what they do.
If what I am about to relate arouses sympathy, I trust that
it will be bestowed upon the irresponsible patients in whose
behalf I speak — not wasted on one who no longer needs it.

The piece of glass with which I had that morning written
the motto already quoted I had appropriated for a purpose.

all of them instruments of neglect and torture. “Chemical restraint
(sometimes, but improperly, dignified by the term “medical restraint )
consists in the unwise use of temporarily paralyzing drugs, hyoscine being
the popular “dose.” By the use of such drugs a troublesome patient may
be rendered unconscious and kept so for hours at a time. Indeed, very
troublesome patients (especially when attendants are scarce) are not infre¬
quently kept in a stupefied condition for days, or even for weeks, — but only
in institutions where the welfare of the patients is lightly regarded. In
vestigators should remember that the less conspicuous “chemical restraint
is oftentimes used as a substitute for the more spectacular and easily
detected “mechanical restraint,” — and, to the untrained observer, shows
only on the drug bill. By its use any unprincipled management may fool
the public. Therefore the mere absence of mechanical instruments of
restraint cannot be taken as proof that an institution is conducted on Non-
Restraint principles.

A MIND THAT FOUND ITSELF

125

Knowing that I should soon be put in the uncomfortable, but
not necessarily intolerable, embrace of a strait-jacket, my
thought was that I might during the night, in some way or
other, use this piece of glass to advantage — perhaps cut
my way to a limited freedom. To make sure that I should
retain possession of it, I placed it in my mouth and held it
snugly against my cheek. Its presence there did not inter¬
fere with my speech; nor did it invite visual detection. But
had I known as much about camisoles and their adjustment
as I learned later, I should have resorted to no such futile
expedient.

A camisole, or, as I prefer to stigmatize it, a strait- jacket,
is really a tight-fitting coat of heavy canvas, reaching from
neck to waist, constructed, however, on no ordinary pattern.
There is not a button on it. The sleeves are closed at the
ends, and the jacket, having no opening in front, is adjusted
and tightly laced behind. To the end of each blind sleeve
is attached a strong cord. The cord on the right sleeve is
carried to the left of the body, and the cord on the left sleeve
is carried to the right of the body. Both are then drawn
tightly behind, thus bringing the arms of the victim into a
folded position across his chest. These cords are then
securely tied.

After many nights of torture, this jacket, at my urgent and
repeated request, was finally adjusted in such manner that
had it been so adjusted at first, I need not have suffered any
torture at all. This I knew at the time, for I had not failed
to discuss the matter with a patient who on several occasions
had been restrained in this same jacket. It is the abuse
rather than the use of such instruments of restraint against
which I inveigh. Yet it is hardly worth while to distinguish
between “use” and “abuse,” for it is a fact that where the
use of mechanical restraint is permitted, abuse is bound to

126

A MIND THAT FOUND ITSELF

follow. The very fact that there are institutions — many
of them at this time — where no such restraint is ever re¬
sorted to, leads me to dwell at length on the experiences of
this night; for I would, if I could, strike the final blow
which shall drive these instruments of torture from all hos¬
pitals for the insane.

Had not the element of personal spite entered into the
assistant physician’s treatment of me on this occasion, I
should now be pleased to give him the benefit of every doubt.
But there are no doubts; and for the enlightenment of all
men of his type — and the public — I shall point out his
errors. The man’s personality was apparently dual. His
“Jekyll” personality was the one most in evidence, but it
was the “Hyde” personality that seemed to control his ac¬
tions when a crisis arose. It was “Doctor Jekyll” who
approached my room that night, accompanied by the attend¬
ants. The moment he entered my room he became “Mr.
Hyde.” He was, indeed, no longer a doctor, or the sem¬
blance of one. His first move was to take the strait-jacket
in his own hands and order me to stand. Knowing that
those in authority really believed that I had that day at¬
tempted to kill myself, I found no fault with their wish to
put me in restraint; but I did object to having this done by
Jekyll- Hyde. Though a strait- jacket should always be

adjusted by the physician in charge, I knew that as a matter
of fact the disagreeable duty was invariably delegated to
the attendants. Consequently Jekyll-Hyde’s eagerness to
assume an obligation he usually shirked inspired me with the
feeling that his motives were spiteful. For that reason I
preferred to entrust myself to the uncertain mercies of a
regular attendant; and I said so, but in vain. “If you will
keep your mouth shut I’ll be able to do this job quicker,
said Jekyll- Hyde.

A MIND THAT FOUND ITSELF

127

“I’ll shut my mouth as soon as you get out of this room
and not before,” said I. Nor did I. My abusive language
was, of course, interlarded with the inevitable epithets. Yet
these should not have annoyed the doctor at all, and would
not, had he judged them fairly. The more I talked the more
vindictive he became. He said nothing, but, unhappily for
me, he expressed his pent-up feelings in something more
effectual than words. After he had laced the jacket, and
drawn my arms across my chest so snugly that I could not
move them a fraction of an inch, I asked him to loosen the
strait-jacket enough to enable me at least to take a full
breath. I also requested him to give me a chance to dis¬
entangle my fingers which had been caught in an unnatural
and uncomfortable position.

“If you will keep still a minute, I will,” said Jekyll-Hyde.
I obeyed, and willingly too, for I did not care to suffer more
than was necessary. Instead of loosening the strait- jacket
as agreed, this doctor, now livid with rage, drew the cords
in such a way that I found myself more securely and cruelly
held than before. This breach of faith threw me into a
frenzy. Though it was because his continued presence
served to aggravate my condition that Jekyll-Hyde at last
withdrew, it will be observed that he did not do so until he
had satisfied an unmanly desire which an apparently lurking
hatred had engendered. The attendants soon withdrew
and locked me up for the night.

No one incident of my whole life has ever impressed itself
more indelibly on my memory. Within one hour’s time I
was suffering pain as intense as any I ever endured, and be¬
fore the night had passed that pain had become almost
unbearable. My right hand was so held that the tip of one
of my fingers was all but cut by the nail of another, and soon
knife-like pains began to shoot through my right arm as far

128

A MIND THAT FOUND ITSELF

as the shoulder. If there be any so curious as to wish to get
a slight idea of my agony, let him bite a finger tip as hard as
he can without drawing blood. Let him continue the op¬
eration for two or three minutes. Then let him multiply
that effect, if he can, by two or three hundred. In my
case, after four or five hours the excess of pain rendered
me partially insensible to it. But for nine hundred min¬
utes — fifteen consecutive hours — I remained in that
strait- jacket; and not until the twelfth hour, about break¬
fast time the next morning, did an attendant so much as
loosen a cord.

During the first seven or eight hours, excruciating pains
racked not only my arms, but most of my body. For the
first and only time in my life I had hysterics. And, though
I cried and moaned, in fact, screamed so loudly that the
attendants must have heard me, little attention was paid to
me, — probably because of the strict orders from “Mr.
Hyde,” after he had again assumed the role of “Doctor
Jckyll.” I even begged the attendants to loosen the jacket
enough to ease me a little. This they refused to do, and they
seemed to enjoy being in a position to add their consider¬
able mite to my torture.

Before midnight I really believed that I should be unable
to endure the torture and retain my reason. A peculiar
pricking sensation which I now felt in my brain, a sensation
exactly like that of June, 1900, led me to believe that I might
again be thrown out of touch with the world I had so lately
regained. Realizing the awfulness of that fate I redoubled
my efforts to effect my rescue. Shortly after midnight I
did succeed in gaining the attention of the night-watch.
Upon entering my room he found me flat on the floor. 1
had fallen from the bed and perforce remained absolutely
helpless where I lay. I could not so much as lilt my head.

A MIND THAT FOUND ITSELF

129

This, however, was not the fault of the strait- jacket. It
was because I could not control the muscles of my neck
which that day had been so mauled. I could scarcely swal¬
low the water the night-watch was good enough to give me.
This night-watch was not a bad sort of fellow; yet even he
refused to loosen the strait-jacket a fraction of an inch. As
he seemed sympathetic, I can attribute his refusal to nothing
but strict orders issued by the assistant physician.

It will be recalled that I placed a piece of glass in my
mouth before the strait-jacket was adjusted. At midnight
the glass was still there. After the refusal of the night-
watch, I said to him: “Then I want you to go to Doctor
Jekyll” (I, of course, called him by his right name; but to
do so now would be to prove myself as brutal as Mr. Hyde
himself). “Tell him to come here at once and loosen this
jacket. I can’t endure the torture much longer. After
fighting two years to regain my reason, I believe I’ll lose my
mind again. You have always treated me kindly. For
God’s sake, get the doctor!”

“I can’t leave the main building at this time,” said the
night-watch. (Jekyll-Hyde lived in a house about one-
eighth of a mile distant, but within the hospital grounds.)

“Will you then take a message to the assistant physician
who stays here?” (One of the two assistant physicians
had apartments in the main building.)

“I’ll do that,” he replied.

“Tell him how I’m suffering. Ask him to please come
here at once and ease this strait-jacket. If he doesn’t I’ll
be as crazy by morning as I ever was. Also tell him I’ll
kill myself unless he comes, and I can do it, too. I have a
piece of glass in this room and I know just what I’ll do
with it.”

The night-watch was as good as his word. He after-

IO

130

A MIND THAT FOUND ITSELF

wards told me that he had delivered my message. The
doctor ignored it. He did not come near me that night,
nor the next day, nor did Jekyll-Hyde appear until his usual
round of inspection about eleven o’clock the next morning.

“I understand that you have a piece of glass which you
threatened to use for a suicidal purpose last night,” said he,
when he appeared.

“Yes I have, and it’s not your fault or the other doctor’s
that I am not now dead. Had I gone mad, in my frenzy I
might have swallowed that glass.”

“Where is it?” asked the doctor, incredulously.

As my strait- jacket rendered me armless I presented the
glass to Jekyll-Hyde on the tip of a tongue which he had
often heard but never before seen.

XVI

Mine was no suicidal intent. Yet, in my hysterical con¬
dition it is wonderful that I did not swallow that glass even
b)- accident; and had I happened to become irresponsibly
insane as well I might — it is more than probable that
I should have done so by design. The assistant physician
who ignored my midnight request may have been influenced
by ethical reasons — perhaps by a wish not to interfere with
Doctor Jekyfl’s case. If so, ethics of that sort — or the
so-called etiquette of the profession — had best be done
away with in asylums. And, though I am sure that this
physician harbored no feeling of ill-will toward me, he
is, nevertheless, deserving of censure because of his almost
criminal neglect of a patient who, he well knew, had previously
been possessed of suicidal impulses. Indeed, he did not
surely know whether my apparent attempt at suicide that
evening had been real or simply a ruse. But the general
belief was that I had meant to kill myself. The least this
doctor could have done was to take the trouble to investi¬
gate, judge my condition, and deprive me of the piece of

glass I claimed to have — or convince himself that I did not
have it.

Such errors of judgment are, I believe, common. They
are due sometimes to sheer laziness, but probably more often
to the fact that so many insane patients cry “Wolf!” But
annoyance is no excuse for negligence. If doctors are not
willing to do their whole duty and protect all patients at all
hours they should either resign or be summarily discharged.

*3*

132

A MIND THAT FOUND ITSELF

It is to be regretted that so many members of the medical
profession seek and accept positions in hospitals for the in¬
sane, not because of any genuine interest in the work to be
done, but simply as a sort of makeshift which will enable
them to support themselves until they can engage in the
general practice of medicine, or of a certain congenial branch
of it. It is these veritable leeches who generally treat pa¬
tients with the least consideration. They become medical
policemen who make their rounds in a perfunctory way and
resort to the club or its equivalent upon slight provocation.
Though there are without doubt many competent physicians,
fine men, who really have taken up their work among the
insane without any intention of making it their life-work,
these men have immediately appreciated the opportunity
for the life of noble unselfishness which lies before them,
and, grasping that opportunity, have wrought excellent re¬
sults — considering the inadequate equipment with which, in
most instances, they have been compelled to work. What
surprises me is that so many thoroughly efficient physicians
have been willing to work year in and year out for salaries
which are not so large, by one half, as the income most of
them could surely enjoy in general practice. No class of
men in the world are more deserving of generous treatment
than the competent and considerate men now working among
the insane. As for the incompetent, may their incompetence
be so conspicuous as to effect their prompt discharge!

After fifteen interminable hours the strait-jacket was re¬
moved. Whereas just prior to its putting on I had been in
a vigorous enough condition to offer stout resistance when
assaulted, now, on coming out of it, I was helpless. When
my arms were released from their restricted position the pain

A MIND THAT FOUND ITSELF

T33

was intense. Each and every joint had been racked. I had
no control over the fingers of either hand, and could not have
dressed myself had I been promised my freedom for doing so.
And this, bear in mind, was the effect of a camisole, which
form of restraint hospital officials, when called upon to
testify, so often describe as being harmless and not very un¬
comfortable.

For more than the following week I suffered as already
described, though of course with gradually decreasing
intensity as my racked body became accustomed to the
unnatural positions it was forced to take. This first experi¬
ence occurred on the night of October 18th, 1902. I was
subjected to the like unfair and unnecessary ordeal each
and every night on the following dates : October 19th, 20th,
21st, 22d, 23d, 24th, 25th, 26th, 27th, 28th, 29th, 30th, and
31st, as well as the nights of November 1st, 2d, 3d, 4th,
5th, 6th, and 7th, — twenty-one nights in all, and parts of
each of the corresponding twenty-one days. On more than
one occasion, indeed, the attendant placed me in the strait-
jacket during the day for refusing to obey some slight wish.
This, too, without an explicit order from the doctor in
charge, though perhaps he acted under a general order.1

During most of this restraint I was in the padded cell. A
padded cell is a vile hole. The side walls are padded as high
as a man can reach, as is also the inside of the door. The
worst feature of such cells is the lack of ventilation, which
deficiency of course aggravates the general unsanitary con¬
dition. The cell which I was compelled to occupy was prac¬
tically without heat. As a result I suffered intensely from

1 In some States the law requires that a record of the use of mechanical
restraint and seclusion be kept by hospital officials, and that such record
shall be open to public inspection. This law is a move in the right direc-
tion. Restraint hates Publicity.

134

A MIND THAT FOUND ITSELF

the cold. Frequently it was so cold I could see my breath.
And, though my canvas jacket served to protect part of that
body which it was at the same time racking, I was seldom
comfortably warm. For, once uncovered, my arms being
pinioned, I had no way of re-arranging the tangled blankets.
What little sleep I managed to get I took lying on a filthy
and hard mattress placed on the bare floor.

Lack of ventilation means vitiated and foul air, and viti¬
ated and foul air was the last thing one in my condition should
have been permitted to breathe. I was entitled to an ade¬
quate supply of oxygen, for, being two or three times as
active as any normal person, I was burning up a propor¬
tionately greater amount of tissue. Strangely enough I
was able to hold my own while thus subjected to a
process of slow poisoning; but I am confident that many
a patient, possessed of less stamina, has been seriously
affected, if not permanently injured, by confinement in such
unsanitary dens. To describe the condition of a padded cell
at its worst would violate good taste. As it is likely to be in
an unmentionable condition for hours at a time the serious¬
ness of the situation may be appreciated. The condition of
my mattress was such that I objected to its use; and nothing
so justifies my objection as the fact that it was actually and
immediately heeded. It seems to be the prevailing opinion
that “anything is good enough for a crazy man.” In my
opinion, if the sane suggestions and requests of insane pa¬
tients were complied with, as my suggestion was on this
occasion, hospitals for the insane would become model insti¬
tutions sooner than they will if the needed changes continue
to depend upon indifferent persons in authority.

It is to be regretted that many hospitals for the insane
maintain such cells — either padded or unpaddcd. Like
strait-jackets they can be used to advantage only on the

A MIND THAT FOUND ITSELF

r35

rarest occasions. Therefore they should be abolished. They
have already been abolished by those doctors who are
advocates of Non-Restraint — except in a few instances
where the authorities have not yet given these intelligent
superintendents money enough to provide the added atten¬
tion and equipment necessary to care properly for a patient
during a period of intense excitement.1

The man who was superintendent while I was undergoing
treatment at this hospital had, during his early incumbency,
gained considerable distinction by advocating Non-Restraint.
But, during the latter years of his life, for some reason
unknown to me, he permitted Restraint to be used — in
moderation. Nevertheless, “moderation” means “abuse,” as
my account surely proves. I attribute this doctor’s appar¬
ent change of attitude to his advanced age, which made it
physically impossible for him to give that attention to the
individual case which a proper enforcement of Non-Restraint
requires. In saying this, however, I do not wish to seem un¬
grateful to a man, now dead, who did much for me and would
have done more had he at the time known of the conduct
of his assistant physician.

The present superintendent of this hospital, a man in the
prime of life and a firm believer in Non-Restraint, is placing
the institution on a Non-Restraint basis. The vile padded
cell, already described, no longer exists, and only once or
twice during the past year has a patient been placed in a
strait-jacket, and then only by the direct order and in the
presence of the superintendent himself. Why use a strait-
jacket at all ? Simply because methods of treatment in an

1 In a hospital provided with modern bathing facilities mechanical re¬
straint and “seclusion” need never be resorted to; for modern equipment
includes the so-called “continuous bath,” in which an excited patient may
be placed and kept for hours, until his excitability gives way to a fairly
normal calm. As a rule, patients enjoy the “continuous bath.”

136

A MIND THAT FOUND ITSELF

institution in which mechanical restraint has been used
cannot immediately be changed. Not that the doctors ad¬
vocating Non-Restraint need time to adjust themselves to
the new conditions, but the attendants require both time
and training; and changes also (though not great ones) in
the equipment of the building are necessary. The principle
of Non-Restraint is something which has to be absorbed.
It is an atmosphere of kindliness. It is not unlike the
esprit de corps of the army — a certain standard to be
attained and maintained. When attendants once appreciate
the significance and advantages of it they invariably take
great pride in proving that they have the faculty for con¬
trolling patients without resorting to any other force than that
of kindliness — one of the greatest and least used of all forces.

For this period of three weeks — from October 18th until
November 8th, 1902, when I left this institution and was
transferred to a state hospital for the insane — I was con¬
tinuously either under lock and key (in the padded cell or
some other room) or under the eye of an attendant. Over
half the time I was in the snug but cruel embrace of a
strait-jacket — about three hundred hours in all. While
being subjected to this terrific abuse I was held in an exile
as complete as that of a Siberian convict. I was cut off
from all direct and all honest indirect communication with
my legally appointed conservator, and also with all relatives
and friends. I was even cut off from satisfactory com¬
munication with the superintendent, who was a real friend
and one who would not have permitted me to suffer so had
he known the truth. To be sure, he knew that I was
being subjected to restraint, but he supposed it was such
as he himself would have administered under like circum-

A MIND THAT FOUND ITSELF

137

stances, restraint which, though unpleasant, need not have
amounted to torture. Being in exile and deprived more
completely of my rights than a justly condemned murderer
who had all but forfeited his life, I saw the superintendent
but twice, and then for so short a time that I was unable
to give him any convincing idea of my plight. These inter¬
views occurred on two Sundays that fell within my period of
exile, for it was on Sunday that the superintendent usually
made his weekly round of inspection. What chance had I
of successfully advocating my cause while my pulpit was a
padded cell, and the congregation — with the exception of
the superintendent — the very attaches who had been abus¬
ing me? At such times my pent-up indignation poured
itself forth in such a disconnected way that my protests were
robbed of their right ring of truth. For all that, I was not
then, or at any time, incoherent in speech. I was simply
voluble and digressive — a natural incident of elation. Such
notes as I managed to write on scraps of paper were inva¬
riably confiscated by the assistant physician. At all events,
it was not until some months later that the superintendent
was informed of my treatment, when, at my request, no less
a person than the Governor of the State discussed the sub¬
ject with him. How I brought about that discussion while
still virtually a prisoner will be narrated in due time. And
not until several days after I had left this institution and had
been placed in another, when for the first time in six weeks I
saw my conservator, did he learn of the treatment to which I
had been subjected. From his office in New Haven he had
on several occasions called up the assistant physician and
inquired about my condition. Though the doctor did tell
him that I was highly excited and difficult to control he did
not even hint that I was being subjected to any unusual re¬
straint. Dr. Jekyll deceived every one, and — as things

138

A MIND THAT FOUND ITSELF

have turned out — deceived himself ; for, had he realized
then that I should one day be able to do what I am now
doing, his brutal instincts would surely have been checked
by his cowardly ones.

How helpless, how at the mercy of his keepers, a man who
enters an asylum may be, is further illustrated by the conduct
of this same doctor. Once, during the third week of my
experience in a strait-jacket, I refused to take certain med¬
icine which the attendant offered me. For some time I had
been regularly taking this innocuous concoction without pro¬
test; but I now decided that as the attendant refused most
of my requests I should no longer comply with all of his. He
did not argue the point with me. He simply reported my
refusal to Doctor Jekyll. A few minutes later Doctor Jekyll
— or rather Mr. Hyde — accompanied by three attendants,
entered the padded cell. I was robed for the night — in a
strait-jacket. Mr. Hyde held in his hand a rubber tube.
An attendant stood near with the medicine. For over two
years, threats had been made that the “tube” would be re¬
sorted to if I refused medicine or food. I had begun to
look upon it as a myth; but its presence in the hands of an
oppressor now convinced me of its reality. I saw that the
doctor and his bravos meant business; and, as I had already
endured torture enough, I determined to make every conces¬
sion this time and escape what seemed to be in store for me.

“What are you going to do with that?” I asked, fixing
my eye on the tube.

“The attendant says you refuse to take your medicine.
We are going to make you take it.”

“I’ll take your old medicine,” was my reply.

“You have had your chance,” said Mr. Hyde.

“All right,” I said. “Put that medicine into me any way
you think best. But the time will come when you’ll wish

A MIND THAT FOUND ITSELF

!39

you hadn’t. When that time does come it won’t be easy to
prove that you had the right to force a patient to take
medicine he had offered to take. I know something about
the ethics of your profession. You have no right to do
anything to a patient except what’s good for him. You
know that. All you are trying to do is to punish me, and I
give you fair warning I’m going to camp on your trail till
you are not only discharged from this institution, but ex¬
pelled from the State Medical Society as well. You are a
disgrace to your profession, and that society will attend to
your case fast enough when certain members of it, who are
friends of mine, hear about this. Furthermore, I shall re¬
port your conduct to the Governor of the State. He can
take some action even if this is not a state institution. Now,
damn you, do your worst!”

Coming from an insane man this was rather straight talk.
The doctor was noticeably disconcerted. Had he not feared
to lose caste with the attendants who stood by I think he
would have given me another chance. But he had too much
pride and too little manhood to recede from a false position
once taken. I no longer resisted, even verbally, for I no
longer wanted the doctor to desist. Though I did not an¬
ticipate the operation with pleasure, I was eager to take
the man’s measure. He and the attendants knew that I
usually kept a trick or two even up the sleeve of a strait-
jacket, so they took added precautions. I was flat on my
back, with simply a mattress between me and the floor. One
attendant held me. Another stood by with the medicine
and with a funnel through which, as soon as Mr. Hyde
should insert the tube, the dose was to be poured. The
third attendant stood near as a reserve force. Though the
insertion of the tube, when skilfully done, need not cause suf¬
fering, the operation as conducted by Mr. Hyde was painful.

140

A MIND THAT FOUND ITSELF

Try as he would he was unable to insert the tube properly,
though in no way did I attempt to balk him. His embar¬
rassment seemed to rob his hand of whatever cunning it
may have possessed. After what seemed ten minutes of
bungling, though it was probably not quite five, he gave up
the attempt, but not until my nose had begun to bleed.
He was plainly chagrined when he and his bravos retired.
Intuitively I felt that they would soon return. That they
did, armed with a new implement of war. This time the
doctor inserted between my teeth a large wooden peg — to
keep open a mouth which he usually wished closed. He
then forced down my throat a rubber tube. Then the at¬
tendant adjusted the funnel, and the medicine, or rather
liquid — for its medicinal properties were without effect
upon me — was poured in.

This medicine was supposed to be soporific in effect. If
I was so greatly in need of sleep, was an hour of intense
mental excitement and physical torture likely to induce it?
The spite of this man who thus tried to discipline me was
evident. Though I am confident that few doctors in charge
of the insane act as unprofessionally and unfairly as he did,
there are, I believe, men of his type to be found in every
State in the Union. And they will continue to prey upon
the insane until Non-Restraint becomes the watchword of
all.

XVII

As the scant reports sent to my conservator during these
three weeks indicated that I was not improving as he had
hoped, he made a special trip to the institution to investigate
in person. On his arrival he was met by none other than
Doctor Jekyll, who told him that I was in a highly excited
condition, which, he intimated, would be aggravated by a
personal interview. Now for a man to see his brother in
my plight would be a distressing ordeal, and, though my
conservator came within two hundred feet of my prison cell,
it naturally took but a suggestion to dissuade him from
coming nearer. Doctor Jekyll did tell him that it had been
found necessary to place me in “restraint” and “seclusion”
(the professional euphemisms for “strait-jacket,” “padded
cell,” etc.), but no hint was given that I had been roughly
handled. Doctor JekylPs politic dissuasion was no doubt
inspired by the knowledge that if ever I got within speaking
distance of my conservator nothing could prevent my
giving him a circumstantial account of my sufferings —
which account would have been corroborated by the black¬
ened eye I happened to have at the time. Indeed, in dealing
with my conservator, the assistant physician showed a degree
of tact which, had it been directed toward myself, would
have sufficed to keep me tolerably comfortable.

My conservator, though temporarily stayed, was not con¬
vinced. He felt that I was not improving where I was, and
he wisely decided that the best course would be to have me
transferred to a public institution — the State Hospital. A

142

A MIND THAT FOUND ITSELF

few days later the judge who had originally committed me
ordered my transfer. Nothing was said to me about the
proposed change until the moment of departure, and then
I could scarcely believe my ears. In fact I did not believe
my informers; for three weeks of abuse, together with my
continued inability to get in touch with my conservator, had
so shaken my reason that there was a partial recurrence of
old delusions. I imagined myself on the way to the State
Prison, a few miles distant; and not until the train had
passed the prison station did I believe that I was really on
my way to the State Hospital for the Insane.1

1 The managements of institutions where the insane are received and
treated should, without further delay, adopt the sensible system of nomen¬
clature now in use in several States in the Union. For instance, in New
York, the “State Hospitals for the Insane” are designated as follows:
Hudson River State Hospital, Willard State Hospital, Manhattan State
Hospital, etc. The word “insane” does not appear in the name or on the
stationery of an institution, where it is so likely to offend sensitive inmates
and their relatives. The phrase “State Hospital,” with appropriate words
preceding, — preferably a word or words suggesting its location, — is all the
designation needed. A general adoption of this suggestion will render
obsolete the already archaic but still used names: “Lunatic Asylum,”
“ Insane Asylum,” “Insane Hospital” and “Hospital for the Insane.” In
this book the latter name is repeatedly used, — not from choice, however,
but because it is the one in general use at present. The main point is that
people should learn to avoid the unnecessary use of words weighted with
misconceptions of the past.

During recent years the words “lunacy” and “insanity” have been
eliminated from the names of several State Boards and Commissions. In
New York, what was once known as the “State Commission in Lunacy”
is now known as the “State Hospital Commission,” while in Massachusetts
that which was once called the “State Board of Insanity” is now known
as the “Massachusetts Commission on Mental Diseases.” The next change
in the name of such commissions as these will, it would seem, result in their
being called “Mental Hygiene Commissions,” for the more progressive
Boards and Commissions have already begun to do work in prevention.

XVIII

The State Hospital for the Insane in which I now found
myself, though in many respects above the average of such
institutions, is typical. It commands a wide view of a beauti¬
ful river and valley. This view I was permitted to enjoy —
at first. Those in charge of the institution which I had just
left did not give my new custodians any detailed account of
my case. Their reticence was, I believe, occasioned by
chagrin rather than charity. Tamers of wild men have as
much pride as tamers of wild animals (but unfortunately
less skill) and to admit defeat is a thing not to be thought
of. Though private institutions are prone to shift their
troublesome cases to state institutions, there is a deplorable
lack of sympathy and co-operation between them, which in
this instance, however, proved fortunate for me.

From October 18th until the early afternoon of November
8th, at the private institution, I had been classed as a raving
maniac. The name I had brought upon myself by experi¬
mental conduct; the condition had been aggravated and
perpetuated by the stupidity of those in authority over me.
And it was the same experimental conduct on my part, and
stupidity on the part of my new custodians, which gave
rise, two weeks later, to a similar situation. On Friday,
November 7th, I was in a strait-jacket. On November 9th
and loth I was apparently as tractable as any of the twenty-
three hundred patients in the State Hospital — convention¬
ally clothed, mild mannered, and, seemingly, right minded.
On the 9th, the day after my arrival, I attended a church

143

144

A MIND THAT FOUND ITSELF

service held at the hospital. My behavior was not other
than that of the most pious worshiper in the land. The
next evening, with most exemplary deportment, I attended
one of the dances which are held every fortnight during the
winter. Had I been a raving maniac such activities would
have led to a disturbance; for maniacs, of necessity, disre¬
gard the conventions of both pious and polite society. Yet,
on either of these days, had I been in the private institution,
I should have occupied a cell and worn a strait-jacket.

The assistant superintendent, who received me upon my
arrival, judged me by my behavior. He assigned me to one
of two connecting wards — the best in the hospital — where
about seventy patients led a fairly agreeable life. Though
no official account of my case had accompanied my transfer,
the attendant who had acted as escort and guard had already
given an attendant at the State Hospital a brief account of
my recent experiences. Yet when this report finally reached
the ears of those in authority they wisely decided not to trans¬
fer me to another ward so long as I caused no trouble where
I was. Finding myself at last among friends I lost no time
in asking for writing and drawing materials, which had
so rudely been taken from me three weeks earlier. My re¬
quest was promptly granted. The doctors and attendants
treated me kindly and I again began to enjoy life. My de¬
sire to write and draw had not abated. However, I did not
devote my entire time to those pursuits, for there were plenty
of congenial companions about. I found pleasure in talk¬
ing — more pleasure by far than others did in listening. In
fact I talked incessantly, and soon made known, in a general
way, my scheme for reforming asylums, not only in the
State, but, of course, throughout the world, for my delu¬
sional perspective made the earth look small. The attend¬
ants had to bear the brunt of my loquacity, and they soon

A MIND THAT FOUND ITSELF

145

grew weary. One of them, wishing to induce silence, ven¬
tured to remark that I was so crazy I could not possibly
keep my mouth shut for even one minute. His challenge
aroused my fighting spirit.

“I’ll show you that I can stop talking for a whole day,”
said I. He laughed, knowing that of all difficult tasks this
which I had imposed upon myself was, for one in my con¬
dition, least likely of accomplishment. But I was as good
as my boast. Until the same hour the next day I refused to
speak to any one. I did not even reply to civil questions;
and, though my silence was deliberate and good-natured,
the assistant physician seemed to consider it of a contuma¬
cious variety, for he threatened to transfer me to a less
desirable ward unless I should again begin to talk.

1 hat day of self-imposed silence was just about the longest
I have ever lived, for I was under a word-pressure sufficient
to have filled a book. Any alienist will admit that my per¬
formance was remarkable, and he will further agree that it
was, at least, an indication of a high degree of self-control.
Though I have no desire to prove that at this period I was not
in an abnormal condition, I do wish to show that I had a
degree of self-control that probably would have enabled me
to remain in the best ward at this institution had I not been
intent insanely intent, of course, and yet with a high de¬
gree of deliberation — upon a reformatory investigation.
The crest of my wave of elation had been reached early in
October. It was now (November) that the curve represent-
ing my return to normality should have been continuous
and diminishing. Instead, it was kept violently fluctuating

°r at ^cast ,ts fluctuations were aggravated — by the im¬
positions of those in charge of me, induced sometimes, I
freely admit, by deliberate and purposeful transgressions of
my own. My condition during my first three weeks of exile

II

146 A MIND THAT FOUND ITSELF

had been, if anything, one of milder excitement than that
which had previously obtained during the first seven weeks
of my period of elation. And my condition during the two
weeks I now remained in the best ward in the State Hospital
was not different from my condition during the preceding
three weeks of torture, or the succeeding three weeks of abuse
and privation — except in so far as a difference was occa¬
sioned by the torture and privation itself.

Though I had all along intended to effect reforms in ex¬
isting methods of treatment, my intense and reckless desire
to investigate “violent wards” did not possess me until I
myself had experienced the torture of continued confine¬
ment in such a ward. It was simple to deduce that if one
could suffer as I had while a patient in a private institution,
brutality must exist in a state hospital. So it was that I en¬
tered the State Hospital with a firm resolve to inspect per¬
sonally every type of ward, good and bad. But I was in no
hurry to begin. My recent experience had exhausted me,
and I wished to regain strength before subjecting myself to
another such ordeal. This desire to recuperate controlled my
conduct for a while, but its influence gradually diminished as
life became more and more monotonous. I soon found the
good ward entirely too polite. I craved excitement — action.
And I determined to get it regardless of consequences;
though I am free to confess I should not have had the courage
to execute my plan had I known what was in store for me.

About this time my conservator called to see me. Of
course I told him all about my cruel experiences at the
private institution. My account surprised and distressed
him. I also told him that I knew for a fact that similar
conditions existed at the State Hospital, as I had heard con¬
vincing rumors to that effect. He urged me to behave my¬
self and remain in the ward where I was, which ward, as I

A MIND THAT FOUND ITSELF

147

admitted, was all that one could desire — provided one had
schooled himself to desire that sort of thing. During our
talk I told my conservator that I wished to spend Thanks¬
giving Day at home. He said that that was out of the ques¬
tion, as I was in too excited a condition. His objection was
absolutely fair, but I could not at that time see the jus¬
tice of it. With intense feeling and the forcefulness of
right words I informed him that nothing should prevent
my going to New Haven the following week.

The fact that I was under lock and key and behind what
were virtually prison bars in no way gave me a sense of help¬
lessness. I firmly believed that I should find it easy to
effect my escape and reach home for the Thanksgiving Day
celebration. And, furthermore, I knew that, should I reach
home, I should not be denied my portion of the good things
to eat before being returned to the hospital. (After a famine,
love of food is hkely to be as strong as love of home.) Bein^
under the spell of an intense desire to investigate the “vio¬
lent ward,” I concluded that the time for action had come.

I reasoned, too, that it would be easier and safer to escape
from that ward — which was on a level with the ground —
than from a ward three stories above it. The next thing I
did was to inform the attendants and several of the patients
that within a day or two I should do something to cause mv
removal thither. They of course did not believe that I had
any idea of deliberately inviting such a transfer, for the
violent ward to an inmate of a hospital for the insane is
what a prison is to a sane and free man. My very frank¬
ness disarmed the attendants.

On the evening of November 21st I went from room to
room collecting all sorts of odds and ends belonging to other
patients. These I secreted in my room. I also collected
a small library of books, magazines, and newspapers. After

I48 a mind that found itself

securing all the booty I dared, I mingled with the other
patients until the time came for going to bed. The attend¬
ants soon locked me in my junk shop and I spent the rest
of the night setting it in disorder. My original plan had been
to barricade the door during the night, and thus hold the
doctors and attendants at bay until those in authority had
accepted my ultimatum, which was to include a Thanksgiv¬
ing visit at home. But before morning I had slightly al¬
tered my plan. My sleepless night of activity had made me
ravenously hungry, and I decided that it would be wiser not
only to fill my stomach but to lay by other supplies of food
before submitting to a siege. Accordingly I set things to
rights and went about my business the next morning as
usual. At breakfast I ate enough for two men, and put in
my pockets bread enough to last for twenty-four hours at
least. Then I returned to my room and at once barricaded
the door. My barricade consisted of a wardrobe, several
drawers which I had removed from the bureau, and a num¬
ber of books, — among them “ Paradise Lost ” and the
Bible, which books I placed in position, with conscious
satisfaction, as a key-stone. Thus the space between the
door and the opposite wall of the room was completely filled.
My room-mate, a young fellow in the speechless condition in
which I had been during my period of depression, was in
the room with me. This was accidental. It was no part of
my plan to hold him as a hostage, though I might finally have
used him as a pawn in the negotiations had my barricade
resisted the impending attack longer than it did. It is a
common trick for insane patients to barricade their doors,
and such situations when they arise are rightly regarded as
serious. The conduct of the patient who has thus isolated
himself is, to those in authority, entirely a matter of con¬
jecture. Though certain types of patients may safely be left

A MIND THAT FOUND ITSELF

149

in their elected seclusion, one as excited as I was on this
occasion, of course, had to be brought to bay. It was not
long before the attendants realized that something was
wrong. They came to my door and asked me to open it. I
refused, and told them that to argue the point would be a
waste of time. They tried to force an entrance. Failing in
that, they reported to the assistant physician. At first he
parleyed with me. I good-naturedly, but emphatically, told
him that I could not be talked out of the position I had
taken; nor could I be taken out of it until I was ready to
surrender, for my barricade was one that would surely hold.
I also announced that I had carefully planned my line of
action and knew what I was about. I complimented him on
his hitherto tactful treatment of me, and grandiloquently —
yet sincerely — I thanked him for his many courtesies. I
also expressed entire satisfaction with the past conduct of
the attendants. In fact, on that part of the institution in
which I was then confined I put the stamp of my capricious
appro\al. But,” said I, “I know that there are wards in
this hospital where helpless patients are brutally treated;
and I intend to put a stop to these abuses at once. Not
until the Governor of the State, the judge who committed
me, and my conservator come to this door will I open it.
When they arrive we’ll see whether or not patients are to be
robbed of their rights and abused.”

My speech was made through a screen transom over the
door. In print it has a highly sane and connected appear¬
ance; but my course of action was rightly construed as
symptomatic of elation; and the doctor acted wisely in re¬
fusing to be reassured. For a few minutes he continued
his persuasive methods. That he should even imagine that
I would basely recede from my high and mighty position,
only irritated me the more.

i5°

A MIND THAT FOUND ITSELF

“You can stand outside that door all day if you choose,”
I said. “ I won’t open it until the three men I have named
appear. I have prepared for a siege; and I have enough
food in this room to keep me going for a day anyway.”

My ultimatum was in fact couched in more vituperative
terms and naturally nettled the doctor. Besides, he was, no
doubt, apprehensive for my room-mate, fearing perhaps that
I might make his life the price of a refusal to summon the
State authorities at my bidding. Realizing at last that no
argument would move me, he set about forcing an entrance.
First he tried to remove the transom by striking it with a
stout stick. I gave blow for blow and the transom remained
in place. To this day it shows the marks of the conflict. A
carpenter was then sent for, but before he could go about his
work one of the attendants managed to open the door enough
to thrust in his arm and shove aside my barricade. I did
not realize what was being done until it was too late to inter¬
fere. The door once open, in rushed the doctor and four
attendants. Without ceremony I was thrown upon the bed,
with two or three of the attacking force on top of me. Again
I was choked, this time by the assistant physician. Though
I am of the opinion that such action on his part was totally
uncalled for, especially so because of its demoralizing effect
upon the attendants present, I wish to credit him with a de¬
gree of skill which enabled him to accomplish his purpose
without any serious bruising of my throat, d he operation
was a matter of only a moment. But before it was over I
had the good fortune to deal the doctor a stinging blow on
the jaw, for which (as he was about my own age and the
odds were five to one) I have never felt called upon to

apologize.

Once I was subdued each of the four attendants attached
himself to a leg or an arm and, under the direction of the doc-

A MIND THAT FOUND ITSELF

*5*

tor, I was carried bodily through two corridors, down two
flights of stairs, and to the “violent ward.” My dramatic
exit startled my fellow patients, for so much action in so
short a time is seldom seen in a quiet ward. And few
patients placed in the “violent ward” are introduced with so
impressive an array of camp-followers as I had that day.

All this to me was a huge joke, with a good purpose be¬
hind it. Though excited I was good-natured and, en route
to my new quarters, I said to the doctor: “Whether you be¬
lieve it or not, it’s a fact that I’m going to reform these in¬
stitutions before I’m done. I raised this rumpus to make
you transfer me to the violent ward. What I want you to do
now is to show me the worst you’ve got.”

“You needn’t worry,” said the doctor. “You’ll get it.”

He spoke the truth. I did “get it.”

XIX

In this country on December 31st, 1903, there were two
hundred and twenty-six public and one hundred and two
private hospitals for the insane. The majority of these, ex¬
cept the smallest of the private institutions, must have at
least two “violent wards” — one for the men, one for the
women. Some of the larger hospitals have several such
wards. Therefore, it may safely be assumed that there are,
all told, about seven hundred wards of this character in
which not fewer than fift n thousand patients are confined.
Of these thousands, many live, as it were, near the very
crater of a volcano of trouble; and many of the other
patients live on the uncertain slopes of this same volcano
— within a zone of constant menace.

Throughout the country, so-called “violent wards” differ
considerably. Of the worst of them, I say “so-called” out
of deference to the doctors who work among the insane. For
you will never hear one of them say “violent ward.” That
term offends their sensibilities. They refer to such wards
as “excited wards,” “strong wards,” “back wards,” or
“disturbed wards.” I wish that I might honestly adopt
their “perfumed phrases,” but I cannot. A “violent ward”
is not a place where insane patients violently attack their
keepers or fellow-patients, except in the rarest of instances,
and then, as a rule, only after they have been goaded into a
revengeful madness by unremitting cruelty. In a word,
a “violent ward” is too often a ward wherein violence is
done to helpless patients by ignorant, untrained, and un-

152

A MIND THAT FOUND ITSELF

T53

sympathetic attendants. However, in justice to a consider¬
able and increasing number of institutions where patients
are uniformly treated with consideration, I wish to state
that in these well managed hospitals no ward is deserving
of the name “violent ward.” But this admission only
strengthens my contention that it is the character of the
attendants in charge of the troublesome cases, and not the
disposition of the patients themselves, which makes a ward
a “violent ward.”

Even for a “violent ward” my entrance was spectacular
if not dramatic. The three attendants regularly in charge
naturally jumped at the conclusion that, in me, a trouble¬
some patient had been foisted upon them. They noted my
arrival with an unpleasant curiosity, which in turn aroused
my curiosity, for it took but a glance to convince me that my
burly keepers were typical attendants of the brute-force type.
Acting on the order of the doctor in charge, one of these at¬
tendants stripped me of my outer garments, and, clad in
nothing but underclothes, I was thrust into a cell. Few,
if any, state prisons in this country contain worse holes than
this cell proved to be. It was one of five, situated in a short
corridor adjoining the main ward. It was about six feet wide
by ten feet long and of a good height. A heavily screened
and barred window admitted light and a negligible quantity
of air — for the ventilation scarcely deserved the name. The
walls and floor were bare, and there was no furniture. A
patient confined here must lie on the floor with no substitute
for a bed but one or two felt druggets. Sleeping under such
conditions becomes tolerable after a time, but not until one
has become accustomed to lying on a surface nearly as hard
as stone. Here (as well, indeed, as in other parts of the ward)

J54

A MIND THAT FOUND ITSELF

for a period of three weeks I was permitted, yes, forced —
to breathe and re-breathe air so vitiated that even when I
occupied a larger room, doctors and attendants seldom
entered without remarking its quality; — this, too, at a time
when the restoration of my physical and mental health es¬
pecially demanded pure air and plenty of it. My first meal
increased my distaste for my semi-sociological experiment.
For over a month I was kept in a half-starved condition. At
each meal, to be sure, I was given the usual portion of
food served to the other patients, but an average portion
of such food is not sufficient to repair the prodigal waste of
brain and bodily tissue which is symptomatic of elation.

Worst of all, it was winter, and these, my first quarters,
were without heat. As one’s olfactory nerves soon become
uncommunicative, the breathing of foul air is not a conscious
hardship. To be famished the greater part of the time, on
the other hand, is a very conscious hardship. But to be
half-frozen, day in and day out for a long period, is exqui¬
site torture. Of all the suffering I endured, that occasioned
by confinement in cold cells seems to have made the most
lasting impression. Hunger is a local disturbance, but when
one is cold every nerve in the body registers its call for help.
Long before reading a certain passage of De Quincey’s I had
decided that cold could cause greater suffering than hunger;
consequently, it was with great satisfaction that I read the
following sentences from his “Confessions”: “O ancient
women, daughters of toil and suffering, among all the hard¬
ships and bitter inheritances of flesh that ye are called upon to
face, not one — not even hunger — seems in my eyes compar¬
able to that of nightly cold. ... A more killing curse there
does not exist for man or woman than the bitter combat be¬
tween the weariness that prompts sleep and the keen, search¬
ing cold that forces you from that first access of sleep to start

A MIND THAT FOUND ITSELF

J55

up horror-stricken, and to seek warmth vainly in renewed
exercise, though long since fainting under fatigue.”

The hardness of the bed and the coldness of the room were
not all that interfered with sleep. The short corridor in

which I was placed was known as the “Bull Pen” _ a

phrase eschewed by the doctors.1 It is so called, I suppose,
because it is usually in an uproar — especially during the
dark hours of the early morning. Patients in a state of
excitement may sleep during the first hours of the night, but
seldom all night, and even should one have the capacity to
do so, his companions in durance would wake him up with a
shout, or a song, or a curse, or the kicking of a door. A
noisy and chaotic medley frequently continues without inter¬
ruption for hours at a time. Noise, unearthly noise, is the
poetic license allowed the occupants of these cells. I spent
several days and nights in one or another of the cells of the
Bull Pen and I question whether I averaged more than
two or three hours’ sleep a night during that time. Seldom do
the regular attendants pay any attention to the noise, though
even they must at times be disturbed by it. In fact the only
person likely to attempt to stop it is the night-watch, who,
when he does enter a cell for that purpose, invariably kicks or
chokes the noisy patient into a state of temporary quiet. I
noted this and scented trouble.

Drawing and writing materials having been again taken
from me, I cast about for some new occupation. As soon

e term Bull Pen ” has many meanings. It is perhaps, more com-
00 l aPI,lled to walled-in or fenced-in enclosures where insane patients
may e herded together, and, at a minimum of effort on the part of those in
authority be glven deceptive and anything but beneficial tastes of such re-
s ncted liberty as must, of necessity, fall to the lot of the insane. The more

SSUr!ndentSOfoUr hospitals for the insane condemn the use of
l ens, and are able to do without them simply by turning the patients

preserve od ®T ^ gCner°US and IjlatinS attendants on guard to
preserve order and prevent escapes.

1 56 A MIND THAT FOUND ITSELF

as I was transferred to a room with a bed, I found an occu¬
pation in the problem of warmth. Though I gave repeated
expression to the benumbed messages of my tortured nerves,
the doctor refused to return my clothes. For a semblance
of warmth I was forced to depend upon ordinary undergar¬
ments and an extraordinary imagination. The heavy felt
druggets were about as plastic as blotting paper and I de¬
rived little comfort from them until I hit upon the idea of
rending them into strips. These strips I would weave into a
crude Rip Van Winkle sort of suit; and so intricate was the
warp and woof thereof that the attendant had to cut me out
of it each morning. At first, until I acquired the destruc¬
tive knack, the tearing of one drugget into strips was a task
of four or five hours. But in time I became so proficient
that I could completely destroy two, sometimes three, of
these six-by-eight druggets in a single night. During the
following weeks of my close confinement I destroyed more
than twenty of these druggets, each worth about four
dollars; — and I confess, I found a peculiar satisfaction in
the destruction of property belonging to a State which had
deprived me of all my effects — except underclothes. But
my destructiveness was due to a variety of causes. It was
occasioned primarily by a “pressure of activity,” for which
the tearing of druggets served as a vent. A phrase used by
me in a letter written during my first month of elation aptly
describes my condition at this time. Said I, in that letter,
“I’m as busy as a nest of ants.” That my energy should
direct itself toward the only destructible objects at hand —
the druggets — was not surprising; nor was it surprising
that I found a use for the strips, for, as I have already
proved, an insane person’s acts arc often purposeful.
Though the habit of tearing druggets was the outgrowth
of an abnormal impulse, the habit itself lasted longer than

A MIND THAT FOUND ITSELF

I57

it could have done had I not, for so long a time, been
deprived of suitable clothes and been held a prisoner in cold
cells. But another motive soon asserted itself. Being de¬
prived of all the luxuries of life and most of the necessities,
my mother-wit, always conspiring with a wild imagination
for something to occupy my time, led me at last to invade
the field of invention. With appropriate contrariety an
unfamiliar and, by me, hitherto almost detested line of in¬
vestigation now attracted me. Abstruse mathematical
problems which had defied solution for centuries began to
appear easy. To defy the State and its puny representatives
had become mere child’s play, so I forthwith decided to
overcome no less a force than gravity itself.

My conquering imagination soon tricked me into believ¬
ing that I could lift myself by my boot-straps — or rather
that I should do so when my laboratory should contain foot¬
gear that lent itself to the experiment. But what of the
strips of felt torn from the druggets ? Why, these I used as
the straps of my missing boots; and having no boots to stand
in I used my bed as boots. I reasoned that for my scien¬
tific purpose a man in bed was as favorably situated as
a man in boots. Therefore, attaching a sufficient number
of my felt strips to the head and foot of the bed, and, in
turn, attaching the free ends to the transom and the
window-guard, I found the rest very simple. For, next,

I joined these cloth cables in such manner that by pulling
downward I effected a re-adjustment of stress and strain,
and my bed, with me in it, was soon dangling in space. My
sensations at this momentous instant must have been much
like those which thrilled Newton when he solved one of
the riddles of the universe. Indeed, they must have been
more intense, for Newton, knowing, had his doubts; I, not
knowing, had no doubts at all. So epoch-making did this

!58 A MIND THAT FOUND ITSELF

discovery appear to me that I noted the exact position of the
bed so that a wondering posterity might ever afterward
view and reverence the exact spot on the earth’s sur¬
face whence one of man’s greatest thoughts had winged its
way to immortality.

For weeks I believed I had uncovered a mechanical prin¬
ciple which would enable man to defy gravity. And I talked
freely and confidently about it. That is, I proclaimed the
impending results. The intermediate steps in the solution
of my problem I ignored — for good reasons. A blind man
may harness a horse. So long as the horse is harnessed one
need not know the office of each strap and buckle. Grav¬
ity was harnessed — that was all. At the proper time I
should reveal my secret in detail. Meanwhile I felt sure
that another sublime moment of inspiration would intervene
and clear the atmosphere, thus rendering flight of the body
as easy as a flight of imagination.

XX

While my inventive operations were in progress I was
chafing under a sense of the injustice of the unsanitary and
certainly unscientific treatment to which I was being sub¬
jected. In spite of my close confinement in vile cells, for a
period of over three weeks I was denied a bath. I do
not regret this deprivation, for the attendants, who at the
beginning were unfriendly, might have forced me to bathe in
water which had first served for several other patients.
Though such an unsanitary and disgusting practice was
contrary to rules, it was often indulged in by the lazy
brutes who controlled the ward. Investigation has con¬
vinced me that this evil is widespread.

I continued to object to the unsatisfactory portions of food
served me, and perhaps my objections were intensified by an
approaching Thanksgiving. My projected Thanksgiving
trip to New Haven had vanished from my mind, and my
actual experience on that day was in dismal contrast to
what I had originally planned for myself. My attendant,
in the unaccustomed guise of a ministering angel, brought
me the usual turkey and cranberry dinner which, on two of
the three hundred and sixty-five days of each year, is pro¬
vided by an intermittently generous State. Turkey being
the rara avis of the imprisoned, it was but natural that I
should desire to gratify a palate long insulted. I wished not
only to satisfy my appetite but to impress indelibly a mem¬
ory which for months had not responded to so agreeable a
stimulus. While lingering over the delights of this experi-

159

160 A MIND THAT FOUND ITSELF

cnce I forgot all about the ministering angel. But not for
long. He soon returned. Observing that I had scarcely
touched my feast he said, “If you don’t eat that dinner
in a hurry I’ll take it from you.”

“I don’t see what difference it makes to you whether I
eat it in a hurry or take my time about it,” said I. “It’s
the best I’ve had in many a day, and I have a right to get as
much pleasure out of it as I can.”

“We’ll see about that,” said he, and, snatching it away, he
stalked out of the room, leaving me to satisfy my hunger on the
memory of vanished luxuries. Thus did a feast become a fast.

Under this treatment I soon learned to be more noisy
than my neighbors. I was never without a certain humor
in contemplating not only my surroundings, but myself;
and the demonstrations in which I began to indulge were
partly in fun and partly by way of protest. In these I was
assisted, and, at times inspired, by a young man in the room
next mine. He was about my own age and was enjoying
the same phase of exuberance as myself. Not realizing
that most of our ward-mates were less mad than we — or
than we were supposed to be — we talked and sang at all
hours of the night. At the time we believed that the other
patients enjoyed the spice which we added to the restricted
variety of their lives, but later I learned that a majority of
them looked upon us as mere nuisances.

We gave the doctors and attendants no rest — at least
not intentionally. Whenever the assistant physician up
peared we upbraided him for the neglect which was
then our portion. At one time or another we got ourselves
banished to the “Bull Pen” for these indiscretions. Had
there been a viler place of confinement still, our perform¬
ances in the “Bull Pen” undoubtedly would have brought
us to it. But there was neither justice nor remedial effect

A MIND THAT FOUND ITSELF 161

in such procedure. At last the doctor hit upon the expedient
of transferring me to a room more remote from my inspir-
ing, and, I may say, conspiring companion. Talking to
each other ceased to be the easy pastime it had been;
so we gradually lapsed into a comparative silence which
must have proved a boon to our ward-mates. The only
annoyances to which a number of the patients were now
subjected during the night were the disturbing noises which
issued with irregularity, but unfortunate certainty, from the
“Bull Pen.”

On several occasions I perfected plans to escape,— and not
only that but also to liberate others. That I did not make
the attempt was the fault — or merit, perhaps — of a certain
night-watch, whose timidity, rather than sagacity, impelled
him to refuse to unlock my door early one morning, although
I gave him a plausible reason for the request. This night-
watch, I learned later, admitted that he feared to encounter
me single-handed. And on this particular occasion well
might he, for, during the night, I had woven a spider-web
net, in which I intended to enmesh him. Had I succeeded
there would have been a lively hour for him in the violent
ward — had I failed there would have been a lively hour
for me. There were several comparatively sane patients
(especially my elated neighbor) whose willing assistance I
could have secured. Then the regular attendants could
have been held prisoners in their own room, if, indeed, we had
not in turn overpowered them and transferred them to the
“Bull Pen” where the several victims of their abuse might
uve given them a deserved dose of their own medicine.
This scheme of mine was a prank rather than a plot. I had
an inordinate desire to prove that one could escape if he had
a mind to do so. Later I boasted to the assistant physician
ot my unsuccessful attempt to escape.

12

162

A MIND THAT FOUND ITSELF

My punishment for harmless antics of this sort was prompt
in coming. The attendants seemed to think their whole
duty to their closely confined charges consisted in delivering
three meals a day. Between meals he was a rash patient
who interfered with their leisure. Now one of my greatest
crosses was the attendants’ continued refusal to give me a
drink when I asked for it. Except at meals, or on those rare
occasions when I was permitted to go to the wash-room, I
had to get along as best I might with no water, and that too
at a time when I was in a fever of excitement. My polite
requests were ignored; impolite demands were answered
with threats and curses. And this war of requests, demands,
threats, and curses continued until the night of the fourth
day of my banishment. Then the attendants made good
their threats of assault. That they had been trying to goad
me into a fighting mood I well knew, and often accused
them of their mean purpose. They brazenly admitted that
they were simply waiting for a chance to slug me, an
promised to punish me well as soon as I should give them

a slight excuse for doing so.

On the night of November 25th, 1902, the head attendant
and one of his assistants passed my door. They were re¬
turning from one of the dances which, at intervals during
the winter, the management provides for the attaches.
While they were within hearing I asked for a drink of water.
It was a carefully worded request. But they were in a hurry
to get to bed, and refused me with curses. Then I replied

in kind. , , , ,

“If I come there I’ll kill you,” said one of the attendants.

“Well, you won’t get in if I can help it,” said I, as I bracec

my iron bedstead against the door.

My defiance and defences gave the attendants t ie pre¬
text for which they had been waiting; and my success in

A MIND THAT FOUND ITSELF

163

keeping them out for two or three minutes only served to
enrage them. By the time they had gained entrance they
had become furies. One of the attendants was a young man
of twenty-seven. Physically he was a perfect specimen of
manhood; morally he was deficient, — thanks to the de¬
humanizing effect of several years in the employ of different
States of the Union which countenance improper methods
in the care of their insane wards. It was he who attacked
me in the dark of my prison room. The head attendant
stood by, holding a lantern which shed a dim light.

The door once open, I offered no further resistance. First
I was knocked down. Then for several minutes I was
kicked around the room — struck, kneed and choked. My
assailant even attempted to grind his heel into my cheek.
In this he failed, for I was there protected by a heavy beard."
But my shins, elbows, and back were cut by his heavy
shoes; and had I not instinctively drawn up my knees to my
elbows for the protection of my body I should have been
seriously, perhaps fatally, injured. As it was, I was severelv
cut and bruised. When my strength was nearly gone *1
feigned unconsciousness. This ruse alone saved me from
further punishment, for no premeditated assault is ever
ended until the patient is mute and helpless. When they
had accomplished their purpose, they left me huddled in a
comer to wear out the night as best I might - to live or
die for all they cared.

Grange as it may seem I slept well. But not at once,
it nn five minutes I was busily engaged writing an account
o the assault. A trained war- correspondent could not have
puffed himself together in less time. As usual I had re¬
course to my bit of contraband lead pencil — this time a
pencil which had been smuggled to me the very first day of
my confinement in the Bull Pen by a sympathetic fellow-

164

A MIND THAT FOUND ITSELF

patient When he had pushed under my cell door that little
implement of war it had loomed as large in my mind as a
battering-ram. Paper I had none; but I had previously
found walls to be a fair substitute. I therefore now selected
and wrote upon a rectangular spot — about three feet y
two - which marked the reflection of a light in the
corridor just without my transom. Among my collection
of genuine human documents I still have a verbatim copy

of my midnight inscription. _ . .

The next morning when the assistant physician appeared
he was accompanied as usual by the guilty head-attendant
who, on the previous night, had held the lantern during us

vicious partner’s assault. ,

“Doctor,” said I, “I have something to tell you, —and

I glanced significantly at the attendant. “Last night I had
a most unusual experience. I have had many imaginary
experiences during the past two years and a half, and it m y
be that last night’s was not real. Perhaps the whole mg
was phantasmagoric - like what I used to see during t e
first months of my illness. Whether it was so or not I shall
leave you to judge. It just happens to be my impression
that I was brutally assaulted last night. If it was a dream
it is the first thing of the kind that ever left visible evidence

“mhthlt’l uncovered to the doctor a score of bruises and
lacerations. I knew these would be more impressive than
any words of mine. The doctor looked wise, bu said
nothing and soon left the room. The guilty attendant no
to appear unconcerned, and I really believe he thought me
not absolutely sure of the events of the previous night, or

least unaware of his share in them.

Though the doctor in his own mind knew that I had been
abused, he was unable to secure incriminating evidence

A MIND THAT FOUND ITSELF

i65

from the attendants. They of course lied for their mutual
protection. They were too wise to deny that they had en¬
tered my room, but the reasons they gave for entering and
their account of what followed were cut from the black cloth
with which cowards habitually cloak their shame. Of all
the liars in the world, brute attendants are, to my mind,
the meanest. They first assault an imprisoned insane man
when there are no sane eyes or ears to bear witness. Then,
taking advantage of the suspicion with which the statements
of the insane are too often regarded, they lie and lie, and
corroborate their lies according to the code of dishonor which
obtains among them. A fair idea of this code may be gained
from one of its rules; namely, that an attendant shall delib¬
erately turn his back when another attendant is assaulting
a patient. By so doing the attendant is of course able to
tell the doctor should he by some rare chance ask — that
he saw no patient struck by the accused. By telling these
half-truths, attendants are able to retain their positions
for months, sometimes years, — but only in institutions where
“Restraint” is countenanced.

The two attendants in my case deserved immediate dis¬
charge. They could not offer the excuse of self-defense, for
they had to unlock the door to get within my reach. In my
opinion the doctor was at fault both before and after. Surely,
my wounds should have had more weight with him than the
palpable lies of those who inflicted them.

I soon found that usually a restless or troublesome.patient
Placed in the violent ward is assaulted the very first day. This
procedure seems to be a part of the established code of dis¬
honor. The attendants imagine that the best way to gain
control of a patient is to cow him from the first. In fact,
these fellows — nearly all of them ignorant and untrained —
will tell you that “violent cases” cannot be handled in any

i66

A MIND THAT FOUND ITSELF

other way. And in so saying they are often sincere. I recall
the advent of a new attendant, a young man stud\ing to
become a physician. At first he seemed inclined to treat
patients kindly, but he soon fell into brutal ways. His
change of heart was due partly to the brutalizing envi¬
ronment, but more directly to the attitude of the three
hardened attendants who mistook his consideration for cow¬
ardice and taunted him for it. Just to prove his metal he
began to assault patients, and one day knocked me down
simply for refusing to stop my prattle at his command. I
did not openly resent his action, for I knew that I should
only be unmercifully beaten for my temerity. By this time
I had learned the uselessness of physical resistance. For
comfort I dwelt upon the thought that I should one day
deal a death blow to the whole inhuman system which had
dealt so many death blows to the helpless insane.

I found also that an unnecessary and continued lack of
out-door exercise tends to multiply deeds of violence. The
attendants are supposed to take the patients for a walk
at least once a day, and twice, when the weather permits.
Yet the patients in the violent ward (and it is they who most
need the exercise) usually get out of doors only when the
attendants see fit to take them. For weeks a ward-mate —
a man sane enough to enjoy freedom, had he had a home of
his own _ kept a record of the number of our walks. It
showed that we averaged not more than one or two a week
for a period of two months. This too in the face of many
pleasant days which made the close confinement doubly
irksome. The attendants preferred to remain m the ware ,
playing cards, smoking, and telling their kind of stories.
One other fact I observed; namely, that as exercise de¬
creased the number of assaults invariably increased. The
attendants need regular exercise quite as much as the patien s

A MIND THAT FOUND ITSELF

167

and when they fail to employ their energy in this healthful
way, they are likely to employ it at the expense of the bodily
comfort of their helpless charges. It was only because
of a lax system of supervision that they were able thus to
shirk their duty. Daily reports as to the exercising of
patients would correct this common evil.

If lack of exercise produced a need of discipline, on the
other hand each disciplinary move served only to inflame
us the more. Some wild animals can be clubbed into a sem¬
blance of obedience, yet it is a treacherous obedience at best,
and justly so. And that is the only kind of obedience into
which a man can be clubbed. To imagine otherwise of a
human being, sane or insane, is the very essence of insanity
itself. A temporary leisure may be won for the aggressor,
but, in the long run, he will be put to greater inconvenience
than he would be by a more humane method. It was repres¬
sion and wilful frustration which kept me a maniac and
made maniacs of others. Whenever I was released from Jock
and key and permitted to mingle with the so-called violent pa¬
tients, I was surprised to find that comparatively few were by
nature troublesome or noisy. So that I am convinced that
hundreds of patients throughout the country are improperly
confined in violent wards. This is a serious matter; for, it is
relatively as unfair to confine the mildly insane among mad¬
men as to immure the sane among the insane. A patient,
calm in mind and passive in behavior three hundred and sixty
days in the year, may, on one of the remaining days, commit
some slight transgression, or, more likely, be goaded into
one by an attendant — or needlessly led into one by a
tactless physician. At once he is banished to the violent
ward, there to remain for weeks — perhaps indefinitely. His
indiscretion may consist merely in an unmannerly announce¬
ment to the doctor of how lightly the latter is regarded by

j68 a mind that found itself

the patient. Such estimates of a doctor’s capacity, though
insane, are frequently correct, and proportionately galling,
and their truth, the subject of them invariably proves by
condemning the guilty patient to a term of imprisonment in
a ward of chaos. A thoroughly competent physician is
seldom vilified; — for, being competent, he is able to win
the good-will of his wards, and, should he occasionally be
consigned to oblivion by an excited patient, he disregards
the matter, knowing full well that the mouth is but the escape-
valve of an abnormally active mind.

XXI

The self-control which had enabled me to suspend speech
for a whole day now stood me in good stead. It enabled
me to a\ ert much suffering that would have been my portion
had I been like the majority of my ward-mates. Time and
again I surrendered when an attendant was about to chas¬
tise me. But at least a score of patients in this ward were
not so well equipped, and these were viciously assaulted again
and again by the very men who had so thoroughly initiated
me into the mysteries of their black art.

I set myself up as the observer and the reporter of abuses.
My observations convinced me of an anomaly; namely, that
the only patients in a hospital for the insane who are not
likely to be subjected to abuse are the very ones least in need
of care and treatment. The violent, noisy, and troublesome
patient is abused because he is violent, noisy, and trouble¬
some. The patient too weak physically or mentally to
attend to his own wants is frequently abused because of that
very helplessness which makes it necessary for the attend¬
ants to wait upon him. And so of the forty men in the vio¬
lent ward during my fourteen weeks of confinement there,
at least twenty were at one time or another viciously beaten
by some oneof the three attendants, frequently by two at once.

Like fires and railroad disasters, assaults seem to come
in groups. Sometimes days will pass without a single out¬
break. Then will come a veritable carnival of abuse —
due invariably to the attendants’ state of mind, not to an
unwonted aggressiveness on the part of the patients. The

169

170

A MIND THAT FOUND ITSELF

beatings which, by reason of my superior discretion, I escaped
scarcely diminished the sum of punishment. I can recall
as especially noteworthy ten instances of atrocious abuse.
Five patients were chronic victims, beaten frequently as I
was on that night when two attendants broke into my room.
Three of them, peculiarly irresponsible, suffered with es¬
pecial regularity, scarcely a clay passing without bringing
to them its quota of punishment. One of these, almost an
idiot, and quite too inarticulate to tell a convincing story
even under the most favorable conditions, became so cowed
that, whenever an attendant passed, he would circle his
oppressor as a whipped cur circles a cruel master. I saw
him do so time and again. If his avoidance became too
marked the attendant would then and there chastise him for
the implied but unconscious insult.

There was a young man, occupying a cell next to mine in
the Bull Pen, who was so far out of his mind as to be abso¬
lutely irresponsible. His offense was that he could not
comprehend and obey. Compared to his abuse, all that I
suffered in the Bull Pen was as nothing. Day after day I
could hear the blows and kicks as they fell upon his body,
and his incoherent cries for mercy were as painful to hear
as they are impossible to forget. That he survived and to-day
is drawing out an existence in an asylum, is surprising. It
is true, I believe, that his form of insanity is considered
incurable; but that is an additional consideration in favor of
kind treatment.

What wonder that this man who was “violent,” or who was
made violent, would not permit the attendants to dress him !
But he had a half-witted friend, a ward-mate, who cou d
coax him into his clothes during the time when his oppres¬
sors found him most intractable. Even an insane man
can distinguish between friend and foe.

A MIND THAT FOUND ITSELF

171

Of all the patients known to me, one incoherent and irre¬
sponsible man of sixty years I saw assaulted with the great¬
est frequency. This patient was restless and forever
talking or shouting, as any man might if oppressed by his
delusions. He was profoundly convinced that a certain
person had stolen his stomach — an idea inspired perhaps
by the remarkable corpulency of the person he accused. His
loss he would wofully voice even while eating. Of course,
argument to the contrary had no effect; and his monotonous
recital of his imaginary troubles made him unpopular with
the attendants. They showed him no mercy. Each day
— including the hours of the night, when the night-watch
took a hand — he was belabored with fists, broom-handles,
and frequently with the heavy bunch of keys which attend¬
ants usually carry on a long chain. He was kicked and
choked, and his suffering was aggravated by his almost
continuous confinement in the Bull Pen. An exception to
the general rule (for such continued abuse often causes
death) this man lived a long time — five years.

Another victim, forty-five years of age, was one who had
formerly been a successful man of affairs. His was a force¬
ful personality, and the traits of his sane days influenced
his conduct when he became insane. He was in the expan¬
sive phase of paresis, a phase distinguished by an exaggerated
sense of well-being — for delusions of grandeur are a symp¬
tom of this form as well as of several other forms of insanity.
Paresis, as everyone knows, is incurable. Its victim is
doomed — death usually following within three years of
the onset of the disease. In this instance, instead of
trying to make the patient’s last months on earth comfort¬
able, the attendants subjected him to a course of treatment
severe enough to have sent even a sound man to an early
grave. I endured privations and severe abuse for one month

172

A MIND THAT FOUND ITSELF

at the State Hospital. This man suffered in all ways worse
treatment for many months — until finally he was trans¬
ferred to a ward where he received kinder treatment. He
still lives, — another example of man’s endurance.

I became well acquainted with two jovial and witty Irish¬
men. They were common laborers. One was a hod-carrier,
and a strapping fellow. When he arrived at the institution
he was suffering with alcoholic delusional insanity a cur¬
able form. He was at once placed in the violent ward,
though his “violence” consisted of nothing more than an an¬
noying sort of irresponsibility. He irritated the attendants
by persistently doing certain trivial things after they had
been forbidden. For instance, the door to a certain room
he would open and re-open, undoubtedly in response to “false
voices” which perhaps commanded him to do so. The at¬
tendants made no allowance for his condition of mind. His
repetition of a forbidden act was interpreted as deliberate
disobedience. He was physically powerful, and they deter¬
mined to cow him. Of the master assault by which this was
sought to be accomplished I was not an eye-witness. But
I was an ear-witness. It was committed behind a closed
door; and I heard the dull thuds of the blows, and I heard
the cries for mercy until there was no breath left the man with
which he could beg even for his life. For days, that wrecked
Hercules dragged himself about the ward moaning pitifully.
He complained of pain in his side and had difficulty in
breathing, which would seem to indicate that some of his
ribs had been fractured. This man was often punished,
frequently for complaining of the torture already inflicted.
But later, when he began to return to the normal, his good-
humor and native wit won for him an increasing degree of

good treatment.

The other Irishman’s arch offense — a symptom oi his

A MIND THAT FOUND ITSELF

03

disease — was that he gabbled incessantly. He could no
more stop talking than he could right his reason on com¬
mand. Yet his failure to become silent at a word was the
signal for punishment. On one occasion an attendant or¬
dered him to stop talking and take a seat at the further end
of the corridor, about forty feet distant. He was doing his
best to obey, even running to keep ahead of the attendant at
his heels. As they passed the spot where I was sitting, the
attendant felled him with a blow behind the ear; and, in
falling, the patient’s head barely missed the wall.

Addressing me, the attendant said, “Did you see that?”

“Yes,” I replied, “and I’ll not forget it.”

“Be sure to report it to the doctor,” said he — a remark
which showed his contempt, not only for me but for those in
authority; and this contempt the latter at least had earned
by their leniency and indifference.

The reader will already have observed that the years of the
patient are no protection. The attendant who had so terribly
beaten me was particularly flagrant in ignoring the claims
of age. On more than one occasion he viciously attacked
a man of over fifty, who, because of his affliction (paresis)
was virtually a man of seventy. He was a Yankee sailing-
master, who, in his prime, could have thrashed his assailant
with ease and thrown him into the sea. But now he was
helpless and could only submit. However, this man was
not utterly abandoned by his old world. His wife called
often to see him; and, because of his condition, she was per¬
mitted to visit him in his room. Once she arrived in the
nick of time — a few hours after her husband had been
cruelly beaten. Naturally she asked the attendants how he
had come by the hurts — the blackened eye and bruised
head. True to the code, they lied, and declared that the
patient had fallen out of bed, or stumbled against the wall.

I74

A MIND THAT FOUND ITSELF

The good wife, perhaps herself a Yankee, was not thus to be
fooled ; and her growing belief that her husband had been as¬
saulted was confirmed by a sight she saw before her visit
was ended. Another patient — a Frenchman, who was a
target for abuse — was knocked flat two or three times as
he was roughly forced along the corridor by an attendant.

I saw this little affair and I saw that the good wife saw it.
The next day she called again and took her husband home.
And so this distressed woman felt it her duty to assume en¬
tire charge of her mad and really dangerous husband. The
result was that after a few (probably sleepless) nights, she
had to return him to the asylum and trust to God rather than
the State to protect him.

Still another victim was a man sixty years of age. He
was quite inoffensive, and no patient in the ward seemed
to attend more strictly to his own business. Shortly after
my transfer from the violent ward this old man was wantonly
attacked by an attendant who broke the patient s arm.
The attendant (the man who had so viciously assaulted
me) was summarily discharged. Unfortunately, however,
the relief afforded the insane was slight and brief, for this
same brute (as I have since ascertained) soon secured a
position in an asylum a thousand miles distant, where, no
doubt, he continues to indulge his base proclivities.

Death by violence in a violent ward is after all not an un¬
natural death — for a violent ward. The patient of whom
I am about to speak was also an old man — over sixty. Both
physically and mentally he was a wreck. On being brought
to the institution he was at once placed in a cell in the Bull
Pen, probably because of his previous history for violence
while delirious at his own home. But his violence (if it
ever existed) had already spent itself, and had come to be
nothing more than an utter incapacity to obey. His offense

A MIND THAT FOUND ITSELF

*75

was that he was too weak to attend to his common wants.
The day after this patient’s arrival, shortly before noon,
he lay stark naked and helpless upon the bed in his cell.
This I know, for I went to investigate immediately after a
ward-mate had informed me of the vicious way in which
the head-attendant had assaulted the sick man. My in¬
formant was a man whose word regarding an incident of
this character I would take as readily as that of any man I
know. He came to me, knowing that I had taken upon
myself the duty of reporting such abominations. My in¬
formant feared to take the initiative, for, like many other
patients who believe themselves doomed to continued con¬
finement, he feared to invite abuse at the hands of revengeful
attendants. I therefore promised him that I would report
the case as soon as I had an opportunity.

All day long the victim of the attendant’s unmanly passion
lay in his cell in what seemed to be a semi-conscious con¬
dition. I took particular pains to observe his condition, for
I felt that the assault of the morning might result in death.
That night, after the doctor’s regular tour of inspection, the
patient in question was transferred to a room next my own.
The mode of transfer impressed itself upon my memory.
Two attendants — one of them was he who had so brutally
beaten the patient — placed the man in a sheet and, each
taking an end, carried the hammock-like contrivance, with
its inert contents, to what proved to be its last resting-place
above ground. Though I cannot say that the patient’s
body slid or struck against the floor as the attendants pro¬
ceeded, the chances are that men who could assault the help¬
less would not be likely to guard against that possibility.
At least I noted this: the attendants seemed as much con¬
cerned about their burden as one might about a dog in a
sack, weighted and ready for the river.

A MIND THAT FOUND ITSELF

176

That night the patient died. Whether he was murdered
none can ever know. But it is my honest opinion that he
was. Though he might never have recovered, it is plain
that he would have lived days, perhaps months. And, had
he been humanely, nay, scientifically, treated, who can say
that he might not have been restored to health and home, and
to-day be enjoying life as is the man who had perhaps
murdered him.

According to the hospital records this death was not other
than a natural death. No autopsy was performed, which
fact, in itself, shows that the doctors did not suspect that the
patient had been maltreated; for it is customary to perform
autopsies when incriminating evidence of abuse is discov¬
ered. But, had there been an autopsy, revealing guilt, —
what then? In all probability, no arrests would have been
made, as hospital officials know how difficult it is to secure
evidence sufficient to convict. Conceding that it is difficult
to secure such evidence, I will not admit that rigorous and
intelligent action on the part of those in authority would never
result in the conviction of attendants guilty of assault or
murder; much less will I admit that the neglect of such ac¬
tion, even if uncertain of success, is ever excusable. Hos¬
pital officials, public prosecutors, and jurors, should bear in
mind that, at trials for such crimes, the word of a patient,
sane enough to testify at all, should have greater weight than
the word of an attendant whose self-interest or cowardice
will so often cause him to perjure himself. Further, those
whose duty it is to apprehend and punish criminals should
remember that there are to be found in every institution
attendants possessed of a high sense of honor. These will
not hesitate, under right conditions, to testify against a
guilty co-worker.

It is to an attendant of this type that I shall look for con-

A MIND THAT FOUND ITSELF

J77

vincing corroboration. His is the same story as mine, though
told of a different institution. I resort to it here at the cost
of digression; for, though I believe my statements alone will
con\ ince the average reader, surely the corroborating words
of a man always sane will put my story beyond suspicion, and
at the same time show that attendants placed under similar
brutalizing conditions, the country over, will behave similarly.

While this book was still in draft, I came, by mere chance,
upon a report which appeared in the Courier- J ournal of
Louisville, Kentucky, of the date, September 18th, 1906. It
was written by a young lawyer, a resident of Lexington.
This man, during the early summer of 1906, had worked as
an attendant in the Eastern Kentucky Asylum for the In¬
sane, at Lexington. He was impelled to enter the hospital
as an attendant by the belief that a knowledge of insanity
might prove of value when he should engage in the practice
of law. He did not enter the employ of the State with the
thought of effecting reform, for the simple reason, as he
told me afterwards, that he was totally ignorant of the neces¬
sity for reform. The evil conditions he discovered shocked
him quite as much as his revelations later shocked an igno¬
rant public.

There was a homicide connected with this Kentucky affair.
The victim was a man thirty-seven years of age. Prior to
his collapse he had held a responsible position in a large
rolling-mill. Working by day in the exhausting heat of a
blast-furnace, and at night nursing a sick wife, he finally
lost his reason. He was at once committed to the State
Hospital. Had he received the treatment he deserved, prob¬
ably he would have recovered, for his form of insanity was
curable. But punishment, not treatment, was to be his cruel
portion. It was administered with such severity that he
died. This fact was proved at the trial of the guiltiest at-
13

A MIND THAT FOUND ITSELF

178

tendant, who, together with another attendant, was convicted
of manslaughter and sent to State’s Prison. Had they killed
a sane person, I believe they would now be serving life-sen¬
tences, if, indeed, they had not been justly condemned to

death.

Another instance of this sort of homicide occurred in
Vermont. An infirm old man, eighty years of age, was wan¬
tonly attacked and killed by two attendants within a week of
his commitment. He was a French-Canadian whose under¬
standing of English had been none too good while he was
sane. When his skill in a foreign tongue had been further
impaired by a clouded understanding, he was of course
doubly helpless. Failing to obey the command of an attend¬
ant with that promptness which conduces to personal safety,
he was attacked and struck with such force that several ribs
were broken. The shock of it all caused his death. The
attendants were indicted for manslaughter, and placed under
bonds of eighteen hundred dollars each. When called to
trial the more culpable of the two, rather than risk his
liberty, forfeited his bond and, as this book goes to press,
has not yet been apprehended. The other attendant ap¬
peared, but, thus far, has not been tried. That men guilty
of such brutality should be given an opportunity to purchase
their freedom by forfeiting a small bond is simply another of
the many injustices legally imposed upon the insane.1 .

The young man who was for a time my neighbor in t re
violent ward, and my companion in mischief, was also

1 Readers of “Hard Cash” may not be familiar with the public corre¬
spondence into which it drew its author, Charles Reade. His letter of Ja -
uary 1 7th 1870, in the Pall Mall Gazette, shows how the ribs of insane patie
col L i broken by brutal keepers with such «,h ^ cvento
leave no external evidence on the body of the victim; and that letter shows
Z how pLlen. then were atrocities of the kind 1 have been descnbtng.
and how easy it was for their perpetrators to escape punishment.

A MIND THAT FOUND ITSELF

*79

terribly abused. This man possessed a distinctive and inter-
esting personality. To-day, could I enjoy his companion-
ship, I should rank him high on my list of those whose
companionship I crave. I am sure I do not exaggerate when
I say that on ten occasions, within a period of two months,
this man was cruelly assaulted — and I do not know how
many times he suffered assaults of less severity. After one
of these doses of unmerited punishment I asked him why he
persisted in his petty transgressions when he knew that he
thereby invited such body-racking abuse.

“Oh,” said he, laconically, “I need the exercise.”

To my mind, the man who, with such gracious humor,
could refer to what was in reality torture, deserved to live
a century. But an unkind fate decreed that he should die
young — and by his own hand. Ten months after his com¬
mitment to the State Hospital he was discharged as improved

but not cured. This is not an unusual procedure; nor
was it in his case apparently an unwise one, for the patient
seemed fit for freedom. During his first month of regained
liberty, this young man hanged himself. No message of
excuse did he leave. In my opinion, none was necessary.
For aught any man knows, the memories of the abuse, tor¬
ture, and injustice, which were so long his portion, may have
pro\ ed to be the last straw which overbalanced the desire to
live. The doctors will say, and truthfully, that it was a sui¬
cidal impulse which drove him to his death. But can they
surely deny that that suicidal impulse might never have
gained control had he been committed to an institution where
not only he, but all other patients would have been treated
kindly and scientifically ? Surely, if thousands who contem¬
plate suicide stop short of it because of some little circum¬
stance, saved by a narrow margin, is it not equally true that
an adverse circumstance may drive a desperate person over
the final brink to his death ?

i8o A MIND THAT FOUND ITSELF

I know of two other instances of young men of about my
own age who committed suicide shortly after release from
their places of confinement. These two had been inmates
of the large private hospital where I had suffered in the strait-
jacket. So far as I know neither of them was subjected to
abuse while there. But one of them who was confined in the
violent ward must have seen patients abused. The other,
who I think would have recovered had he been skilfully tided
over his despondent period, was not at any time confined in
a violent ward. But, if he did not see others roughly han¬
dled, of course he heard the ever-present rumors of abuse.
Such rumors are common topics of conversation in all
asylums, and they undoubtedly have a depressing effect
upon those who need little to convince them that life is not
worth living. When a patient is discharged and enleis
his old world, is it surprising that sometimes he should
choose death rather than take the chance of again enter¬
ing a place which to him is worse than the grave itself ?

If I were to recount each instance of cruelty (major and
petty) which I can recall, my chapter on abuse would soon
become a book of itself. And, if it were possible to put in
book form the stories of the lives of persons who have suffered
experiences such as mine, I firmly believe it would takt sev¬
eral thousand feet of shelving in a Congressional Library to
hold this record of Man’s inhumanity to Man. Fortunately
no such collection of woe ever can be gathered. Read the
few stories of this nature that exist, magnify the impression
gained, and an approximation may be reached. Without
question, during the past century hundreds of insane men
and women have been murdered by their keepers. And
many of these murders were as deliberate as any ever com¬
mitted, for attendants frequently hate unto death certain
of their troublesome charges.

XXII

The so-called “seclusion” vouchsafed to me I have de¬
scribed. If it is true that I stood in need of seclusion at all,
I should have had a bed in a room designed especially for
the treatment of such a case as mine. That room should
have been perfectly ventilated, and competent nurses should
have been in practically constant attendance. My every
reasonable wish (and unreasonable whim, if harmless)
should have been granted. I should have had nourishing
food at proper intervals; and I should have received nothing
but that kindly treatment which can do more toward the
restoration of mental health than all the medicine in the
world.

Patients are weighed at stated intervals. Shortly after
entering the State Hospital I weighed about one hundred
thirty pounds, and that must have been about my weight when
transferred to the “violent ward.” Ten days later, at the
regular monthly weighing, I weighed only one hundred fif¬
teen pounds. Though loss of weight is a symptom of ela¬
tion, I cannot but believe that my rapid decrease was due
mainly to deprivation and abuse.

Before my banishment to the violent ward, the doctor in
charge of my case had granted me many favors; but during
the first ten days of my “seclusion” my sense of gratitude
was dulled by the indignities and the terrific punishment
to which I was subjected. Is it strange, then, that I had
no respect for authority personified by a man who, hold¬
ing me in the vilest of exiles, apparently countenanced the

181

1 82 A MIND THAT FOUND ITSELF

brutal practices of men dependent upon him for their con¬
tinued employment? I refused to be a martyr. Rebellion
was my watchword. The only difference between the
doctor’s opinion of me and mine of him was that he could
refuse utterance to his thoughts. Yes — there was another
difference. Mine could be expressed only in words —
his in grim acts.

I repeatedly made demands for those privileges to which
I knew I was entitled. When he saw fit to grant them
I gave him perfunctory thanks. When he refused — as he
usually did — X at once poured upon his head the vials
of my wrath. Patients with less stamina than I had in¬
variably submit with meekness; and none so aroused my
sympathy as those whose submission was due to the con¬
sciousness that they had no relatives or friends to support
them in a fight for their rights. These, disheartened, usually
bear their burdens with a fortitude which under other con¬
ditions would be sublime.

On behalf of these, with my usual piece of smuggled lead
pencil, I soon began to indite and submit to the olfieers of
the institution letters in which I described the cruel prac¬
tices which came under my notice. My reports were per¬
functorily accepted and at once forgotten or ignored. Yet
these letters, so far as they related to overt acts witnessed,
were lucid and should have been convincing. Furthermore,
my allegations were frequently corroborated by marks on the
bodies of the patients. My usual custom was to write an
account of each assault and hand it to the doctor in authority.
Frequently I would submit these reports to the attendants
with instructions first to read and then deliver them to the
superintendent or the assistant physician. 1 he men whose
cruelty I thus laid bare read my complaints with evident but
perverted pleasure. They would laugh and joke about my

A MIND THAT FOUND ITSELF

183

ineffectual attempts to bring about their discharge. And
their derision seemed justified; for my almost daily reports
were without effect.

My very independence and my impulse to defend others
gave promise of approaching sanity. Yet it was because of
this disturbing audacity that I so long failed of a transfer
to a better ward. One day I would be on the friendliest
terms with the doctor, the next day I would upbraid him
for some denial of my rights, — or, as frequently happened,
for not interposing in behalf of the rights of others. It was
after one of these wrangles that I was placed in a cold
cell in the Bull Pen at eleven o’clock one morning. Still
without shoes and with no more covering than underclothes,

I was forced to stand, sit, or lie upon a bare floor as hard
and cold as the pavement outside. Not until sundown was
I provided even with a drugget, and this did little good, for
already I had become thoroughly chilled. In consequence,

I contracted a severe cold which added greatly to my discom¬
fort, and might have led to serious results had I been of less
sturdy fiber.

This day was the thirteenth of December and the twenty-
second of my exile. I remember it distinctly for it was the
seventy-seventh birthday of my father, to whom I wished
to write a congratulatory letter. This had been my custom
for years when absent from home on that anniversary. And
well do I remember when, and under what conditions, I
asked the doctor for permission. It was night. I was flat on
my drugget-bed. My cell was lighted only by the feeble rays
of a lantern held by an attendant to the doctor on this his
regular visit. At first I couched my request in polite lan¬
guage. The doctor merely refused to grant it. I then put
forth my plea in a way calculated to arouse sympathy. He
remained unmoved. I then pointed out that he was defying

184

A MIND THAT FOUND ITSELF

the law of the State which provided that a patient should
have stationery — a statute, the spirit of which at least
meant that he should be permitted to communicate with his
conservator.1 But my arguments were of no avail. The
doctor had set himself up as despot, and despot he remained.
It was now three weeks since I had been permitted to write
or send a letter to any relative or friend. Why? Because
I would persist in telling the truth about my treatment and
condition. Naturally the management did not desire such
information to be spread. Contrary to my custom, there¬
fore, I made my final demand in the form of a concession.
I promised that I would write only a conventional note of
congratulation, making no mention whatever of my plight.
It was a fair offer; but to accept it would have been an im¬
plied admission that there was something to conceal, and for
this, if for no other reason, it was refused.

Such treatment was not only unfair, it was unsound
from a scientific point of view. I was fighting for my life
and my reason; and the doctor apparently was putting
other obstacles in my way than those which were unavoid¬
able. Surely I was actuated by a sane impulse — the desire
to write to my father on his birthday. And, as sanity itself
simply consists in sane impulses, was it not the duty of that
doctor, rather than to stifle such impulses as they appeared,
to sustain and strengthen them, and, if possible, encourage
them to become preponderant? Instead, day after day, I
was repressed in a manner which probably would have driven

1 See General Statutes of Connecticut § 2764. Patient may communi¬
cate with FRIENDS in writing. All persons detained as insane shal
at all times be furnished with materials for communicating under seal
with any proper person without the asylum, and such communications
shall be stamped and mailed daily. Should the patient desire it all
rational communications shall be written at his dictation and duly mailed
to any relative or person named by the patient.

A MIND THAT FOUND ITSELF

185

many a sane man into a state of madness and violence. Yet
that doctor, forgetful or ignorant of the fact that my behavior
was the direct result of the indignities which he and his under¬
lings were continually heaping upon me, would frequently
exhort me to play the gentleman. Are mild manners and
sweet submission usually the product of such treatment?
Deprived of my clothes, of sufficient food, of warmth, of all
sane companionship, of my liberty and even of those residu¬
ary rights which belong to a madman, I told the doctors that
so long as they should continue to treat me as the vilest of
criminals, I should do my best to complete the illusion.

The burden of proving my sanity was placed upon me. I
was told that so soon as I became polite and meek and lowly
I should find myself in possession of my clothes and of cer¬
tain privileges. In every instance I must earn my reward
before being entrusted with it. If this principle had been
applied in a rational way, if, for instance, instead of demand¬
ing of me all the negative virtues in the catalogue of spineless
saints, the doctor had given me my clothes on the condition
that they would be taken from me again if I so much as re¬
moved a button, — such a course would have been produc¬
tive of good results. Thus I might have had my clothes
three weeks earlier than I did, and so been spared much suf¬
fering from the cold.

I clamored daily for a lead pencil; but for seven weeks
no doctor, attendant, or other attache gave me one. Now a
lead pencil represents the margin of happiness for hundreds of
the insane, while a plug of tobacco represents the margin of
happiness for thousands of others. To be sure, by reason
of my somewhat exceptional persistence and ingenuity, I
managed to be always in possession of some substitute for
a pencil, surreptitiously obtained, - a fact which no doubt
ad something to do with the doctor’s indifference to my

1 86 A MIND THAT FOUND ITSELF

request. But my inability to secure a pencil in a legitimate
way was a needless source of annoyance to me, and many
of my verbal indiscretions were directly inspired by the
doctor’s continued refusal to give me what I well knew
belonged to me by right. Hospital officials will often
justify such a petty deprivation because of an alleged
proneness on the part of the patients to scribble on the
walls. But only in exceptional cases does this mischievous
tendency exist. During my confinement I saw little such
vandalism, and most of that was caused by a dearth of paper
on which to write; and I have since found that in hospitals
where privileges of this sort are freely and promptly granted,
there is a disposition on the part of patients to show their
appreciation by respecting the wishes of their benefactors.
A doctor who has gained the good-will of a patient can, by
speaking kindly to him, deter him from worse transgressions
than scribbling on the walls. But let us admit that a few
patients will transgress. Must the many suffer because of
the irresponsibility of the few ? And what real harm is
done by the few? Surely the instinct to so mark a bare
surface is born of sanity itself. Why else do under¬
graduates sally forth every now and then with a pot of
paint — to earn a fleeting immortality among barbarians
of their own ilk? Inasmuch as Nature herself is everlast¬
ingly carving the earth’s surface, it is not strange that man,
sane and insane, attempts in his feeble way to imitate her.

It was an assistant physician, other than the one regularly
in charge of my case, who at last relented and presented me
with a good lead pencil. By so doing he placed himself
high on my list of benefactors; for that stick of wood
magnified by my lively appreciation became as the eery
axis of the earth.

XXIII

It was a few days before Christmas that my most galling
deprivation was at last removed. That is, my clothes were
restored. These I treated with great respect. Not so much
as, a thread did I destroy. Clothes have a sobering and civil¬
izing effect, and from the very moment I was again provided
with presentable outer garments my conduct rapidly im¬
proved. One of the doctors with whom I had been on such
variable terms of friendship and enmity even took me for a
sleigh- ride. With this improvement came other privileges
or, rather, the granting of my rights. Late in December I
was permitted to write and send letters to my conservator.
Now that I was no longer being treated cruelly the doctor
in charge was willing that I should communicate directly
with my brother. Though some of my blood-curdling
letters were confiscated, a few, detailing my experiences, were
forwarded. The account of my sufferings naturally dis¬
tressed my conservator, but, as he said when he next
visited me: “What could I have done to help you? If the
men in this State whose business it is to care for the insane
cannot manage you, I am at a loss to know what to do.”
True, he could have done little or nothing, for he did not
then know the ins and outs of the baffling game into which
the ties of blood had drawn him.

About the middle of January the doctor in charge of my
case went for a two week’s vacation. During his absence
another member of the staff took charge of the violent ward.

A man of wider experience and more liberal ideas than his

187

!88 A MIND THAT FOUND ITSELF

predecessor, he at once granted me several real privileges.
One day he permitted me to pay a brief visit to the best ward
— the ward from which I had been transferred two months
earlier. I thus was able again to mingle with fairly sane
men, and though I enjoyed this privilege upon but one
occasion, and then only for a few hours, the knowledge
that I could have such privileges for the asking was a
source of intense satisfaction.

Altogether the last six weeks of the fourteen during which
I was confined in the violent ward were comfortable and rel¬
atively happy. I was no longer subjected to physical abuse,
though this exemption was largely due to my own skill in
avoiding trouble. I was no longer cold and hungry. I was
allowed a fair amount of out-door exercise which, after my
close confinement, proved to be a delightful sort of shock.
But, above all, I was again given an adequate supply of
writing and drawing materials, which became as tinder under
the focused rays of my artistic eagerness. My mechanical
investigations were gradually set aside and art and literature
again held sway. Except when out of doors taking my
apportioned exercise, I remained in my room reading, writing
or drawing. This room of mine soon became a Mecca for
the most irrepressible and loquacious characters in the ward.
These self-elected companions at first interfered with my
work. But I soon schooled myself to shut my ears to their
incoherent prattle. Occasionally, some uninvited visitor
would become obstreperous — perhaps because of my lordly
order that he leave the room. At such times, however, I
tested my theory that insane patients in anger can be con¬
trolled by tact. The result was that I invariably induced
them to obey. Often did they threaten to throttle me, but
I ignored the threats, and they were never carried out. Nor
was I afraid that they would be. Had I been a typical

A MIND THAT FOUND ITSELF 189

attendant, I should have accepted them as challenges, with
the usual brutal consequences.

The drawings I produced at this time were crude. For
the most part they consisted of copies of illustrations which
I had cut from magazines that had miraculously found their
way into the violent ward. The heads of men and women
interested me most, for I had decided to take up por¬
traiture. At first I was content to draw in black and
white, but I soon procured some colors and from that time
on I devoted my attention to mastering pastel. With it I
evolved a method which produced an unusual but not an
unpleasing effect. I doubt if a graduate of a recognized
School of Art would dare to discover the secret of my
method. Therefore I shall give up the key to my mystery so
that he who runs may take or leave it. On paper with a
rough surface (such as draughtsmen commonly use) first
draw an outline, using a hard pencil. Then rub in pastel
of the desired color. With the tip of the finger this
can be properly distributed; and the slight indentations
on the surface of the paper, caused by the hard pencil,
will immediately appear as light lines. These lines pro¬
duce a peculiar and striking effect. Though this method
would be of no value in many drawings, in a drawing
in which there is a wealth of hair to be represented it
is very serviceable. With my compliments, this method
(so far as I know, my own) I bequeath to posterity, and
to such living artists as dare to risk their reputation by
adopting it.

In the world of letters I had made little progress. My
compositions were for the most part epistles — addressed to
relatives and friends, and to those in authority at the hospital.
Frequently the letters addressed to the doctors were sent
in sets of three — this to save time, for I was very busy. The

A MIND THAT FOUND ITSELF

190

first letter of such a series would contain my request, couched
in friendly and polite terms. To this I would add a post¬
script, worded about as follows: “If, after reading this letter,
you feel inclined to refuse my request, please read letter num¬
ber two.” Letter number two would be severely formal —
a business-like repetition of the request made in letter num¬
ber one. Again a postscript would advise the reader to
consult letter number three, if the reading of number two
had failed to move him. Letter number three was invariably
a brief philippic in which I would consign the unaccommo¬
dating doctor to oblivion.

In this way I expended part of my prodigious supply of
feeling. But I had also another way of reducing my crea¬
tive pressure. Occasionally, from sheer excess of emotion,
I would burst into verse — of a quality not to be doubted.
Of that quality the reader shall judge, for I am going to
quote a “creation” written under circumstances which, to
say the least, were adverse. Before writing these lines I
had never attempted verse in my life — barring intentionally
inane doggerel. And, as I now judge these lines, it is prob¬
ably true that even yet I have never written a poem. Never¬
theless, my involuntary, almost automatic outburst is at
least suggestive of the fervor that was in me. These four¬
teen lines were written within thirty minutes of the time I
first conceived the idea; and I present them substantially
as they first took form. From a psychological standpoint,
at least, they are not without interest.

LIGHT

Man’s darkest hour is the hour before he’s bom,

Another is the hour just before the Dawn;

From Darkness unto Life and Light he leaps,

To Life but once, — to Light as oft as God wills he should.

’Tis God’s own secret, why
Some live long, and others early die;

A MIND THAT FOUND ITSELF

191

For Life depends on Light, and Light on God,

Who hath given to Man the perfect knowledge
That Grim Despair and Sorrow end in Light
And Life everlasting, in realms
Where darkest Darkness becomes Light;

But not the Light Man knows,

Which only is Light
Because God told Man so.

These verses, which breathe religion, were written in an
atmosphere where religion was almost extinct. With the
curses of madmen ringing in my ears, some subconscious
part of me forced me to write at its dictation. I was far
from being in a pious frame of mind myself, and the quality
of my thought surprised me then — as it does now. Per¬
haps for a moment some ancestor (I have two who went
as missionaries to the Sandwich Islands early in the last cen¬
tury) controlled my thoughts. At any rate I like to think
so, for I should object to being held entirely responsible for
a poem the technical imperfections of which are scarcely
atoned for by the elevation of the theme.

Though I respected my clothes, I did not at once cease to
tear such material as would serve me in my scientific inves¬
tigations. Gravity being conquered, it was inevitable that
I should devote some of my time to the invention of a flying-
machine. This was soon perfected — in my mind; and all
I needed, that I might test the device, was my liberty. As
usual I was unable to explain how I should produce the re¬
sult which I so confidently foretold. But I was secure in
the belief that I should, ere long, fly to St. Louis and claim
and receive the one hundred thousand dollar reward offered
by the Commission of the Louisiana Purchase Exposition for
the most efficient airship there to be exhibited. The mo-

A MIND THAT FOUND ITSELF

192

ment that thought winged its way through my mind, I had
not only a flying-machine, but a fortune in the bank. Being
where I could not dissipate my riches I became a lavish verbal
spender. I was in a mood to buy anything, and I whiled
away many an hour planning what I should do with my
fortune. The St. Louis prize was a paltry trifle. I reasoned
(if my magnificent mental processes may be dignified as
reasoning) that the man who could harness gravity had at
his beck and call the world and all that therein is. This
sudden accession of wealth made my vast humanitarian
projects seem only the more feasible. What could be more
delightful, thought I, than the furnishing and financing of
ideas of a magnitude such as would stagger humanity. My
condition was one of ecstatic suspense. Give me my liberty
and I would show a sleepy old world what could be done to
improve conditions, not only among the insane, but along
every line of beneficent endeavor.

The city of my birth was to be made a garden-spot. All
defiling, smoke-begriming factories were to be banished to
an innocuous distance. Churches were to give way to cathe¬
drals; the city itself was to become a paradise of mansions.
Yale University was to be transformed into the most mag¬
nificent — yet efficient — seat of learning in the world. For
once, college professors were to be paid adequate salaries,
and alluring provision for their declining years was to be
made. New Haven should become a very hot-bed of cul¬
ture. Art galleries, libraries, museums, and theaters of a
dream-like splendor were to rise whenever and wherever I
should will. Why absurd ? Was it not I who would
defray the cost? The famous buildings of the Old World
were to be reproduced, if, indeed, the originals could not be
purchased, brought to this country, and re-erected. Not
far from New Haven there is a sandy plain, once the bed

A MIND THAT FOUND ITSELF

*93

of the Connecticut River, but now a kind of miniature
desert. I often smile as I pass it on the train; for it was
here, for the edification of those who might never be able to
visit the Valley of the Nile, that I planned to erect a pyramid
that should out- Cheops the original. My harnessed grav¬
ity, I believed, would not only enable me to overcome
existing mechanical difficulties, but it would make the
quarrying of immense monoliths as easy as the slicing
of bread.

After all, delusions of grandeur are the most entertaining
of toys. The assortment which my imagination provided
was a comprehensive one. I had tossed aside the blocks
of childhood days. Instead of laboriously piling small
squares of wood one upon another, in an endeavor to
build the tiny semblance of a house, I now, in this second
childhood of mine, projected against thin air phantom
edifices, planned and completed in the twinkling of an eye.
To be sure such houses of cards almost immediately su¬
perseded each other, but the vanishing of one could not
disturb a mind which had ever another interesting
bauble to take its place. And therein lies part of the secret
of the happiness peculiar to that stage of elation which is
distinguished by delusions of grandeur, — always provided
the afflicted one be not subjected to privation and abuse.
The sane man who can prove that he is rich in material
wealth is not nearly so happy as his unfortunate brother
whose delusions trick him into believing himself a modern
Croesus. A wealth of Midas-like delusions is no burden.
Such a fortune, though a misfortune in itself, bathes the
world in a golden glow. No clouds obscure the vision.
Optimism reigns supreme. “Failure” and “impossible” are
as words from an unknown tongue. And the unique satis¬
faction about a fortune of this fugitive type is that its loss
14

194

A MIND THAT FOUND ITSELF

occasions no regret. One by one the phantom ships of treas¬
ure sail away for parts unknown; until when the last
has become but a speck on the mental horizon, the observer
makes the happy discovery that his pirate fleet has left
behind it a priceless wake of Reason 1

XXIV

Early in March, 1903, having lived in a “violent
ward” for nearly four months, I was transferred to another
a ward quite as orderly as the best in the institution,
though less attractively furnished. Here also I had a room
to myself: in this instance, however, the room had not only
a bed, but a chair and a wardrobe. With this elaborate
equipment I was soon able to convert my room into a ver¬
itable studio. Whereas in the violent ward it had been
necessary for me to hide my writing and drawing materials
to prevent their loss, in my new abode I was able to conduct
my literary and artistic operations without the annoyances
which had been inevitable during the preceding months.

Soon after my transfer to this ward I was permitted to go
out of doors and walk to the business section of the city — two
miles distant. But on these walks I was always accom¬
panied by an attendant. To one who has never surrendered
any part of his liberty such surveillance would no doubt seem
irksome; yet, to me, after being so closely confined, the
ever-present attendant seemed a companion rather than a
guard. These excursions into the sane and free world were
not only a great pleasure, they were almost a tonic. To
rub elbows with normal men tends to restore the mental
poise of one whose recovery is imminent. The casual passer¬
by, as a rule, does not distinguish patient from attendant,
if, indeed, the identity of either is suspected. And the
knowledge of this fact gives the patient a feeling of security
which hastens a return of that self-confidence so essential

195

196 a mind that found itself

to the success of one about to re-enter a world from which
he has long been cut off.

It is to be regretted that those in authority at a state hos¬
pital are unable to send many patients on such little excur¬
sions as I have just mentioned. I know that the doctors would
be glad to grant such privileges more freely if a sufficient
number of attendants were available for the purpose. Few
institutions are provided with an adequate force of attend¬
ants. Yet the States could well afford to employ men
and women for no other purpose than that of acting as
escort and guard for those patients whose recovery is only a
question of time. Such treatment would surely shorten
the period of convalescence, and the earlier discharge of the
patient would offset the increased cost of treatment; for
“it is an accepted postulate by specialists who have
examined the question that every recovery from mental
disease, no matter what the cost of obtaining it, is a saving
to the State.” 1 In every community, I believe, there are men
and women who would be glad of the opportunity to perform
such service — for a few hours each day. One of these per¬
sons could be called in whenever a regular attendant could
not be spared for the purpose. Especially would this scheme
prove feasible in those institutions (and there are many
such) situated near a college or university. The students
would thus be able to make appreciable additions to their
income during their term of study* and, far abo\e the
financial gains, they would develop a richness of char¬
acter which must come to him who helps to lift a burden
from the sorely afflicted.

My first trips to the city were made primarily for the pur¬
pose of supplying myself with writing and drawing materials.

iSee Dr. J. Montgomery Mosher’s Fourth Annual Report of Pavilion
F, Department for Mental Diseases at Albany Hospital (Albany, N. Y .).

A MIND THAT FOUND ITSELF

T97

\\ hile enjoying these welcome tastes of liberty, on more than
one occasion I surreptitiously mailed certain letters which
I did not dare entrust to the doctor. Under ordinary cir¬
cumstances such an act on the part of one enjoying a special
privilege would be dishonorable. But the circumstances
that then obtained were not ordinary. I was simply pro¬
tecting myself against what I believed to be unjust and
illegal confiscation of letters.

I therefore need not dilate on the reasons which made
it necessary for me to smuggle, as it were, to the Governor
of the State of which I was a ward, a letter of complaint and
instruction. This letter was written shortly after my trans¬
fer from the violent ward. The abuses of that ward were
still fresh in my mind, and the memory of distressing
scenes was kept vivid by reports reaching me from friends
who were still confined there. These private detectives of
mine I talked with at the evening entertainments, or at
church. From them I learned that brutality had become
more common, if anything, since I had left the ward. Real¬
izing that my crusade against the physical abuse of patients
thus far had proved of no effect, I determined to go over
the heads of the doctors and appeal to the ex-officio head
of the institution, the Governor of the State.

On March 12th, 1903, I wrote a letter which so

disturbed the Governor that he immediately set about an
informal investigation of some of my charges. Despite its
prolixity, its unconventional form and what, under other cir¬
cumstances, would be stigmatized as almost diabolic impu¬
dence and familiarity, my letter, as he said months later
when I conferred with him, “rang true.” The writing of it
was an easy matter; in fact, so easy, because of the pressure
of truth under which I was laboring at the time, that it em¬
bodied a compelling spontaneity.

198 a mind that found itself

The mailing of it was not so easy. I knew that the only
sure way of getting my thoughts before the Governor was
to do my own mailing. Naturally no doctor could be trusted
to send an indictment against himself and his colleagues to
the one man in the State who had the power to institute such
an investigation as might make it necessary for all to seek
employment elsewhere. In my frame of mind, to wish to
mail my letter was to know how to accomplish the wish.
The letter was in reality a booklet. I had thoughtfully used
waterproof India drawing ink in writing it, in order, per¬
haps, that a remote posterity might not be deprived of the
document. The booklet consisted of thirty-two, eight-by-
ten-inch pages of heavy white drawing paper. These I had
bound together by sewing. In planning the form of my
letter I had forgotten to consider the slot of a letter-box of
average size. Therefore I had to hit upon some peculiar
method of getting my letter into the custody of the gov¬
ernment. My expedient was simple. There was in the
town a certain bookstore where I traded. At my request
the doctor gave me permission to go to that store for supplies.

I was of course accompanied by an attendant, who little
suspected what was under my vest. To conceal and carry
my letter in that place had been easy; but to get rid of it
after reaching the bookstore was another matter. Watch
ing my opportunity, I slipped the missive between the
leaves of a copy of the Saturday Evening Post. This I did,
believing that some purchaser would soon discover the letter
and mail it. In fact, so fearful was I of detection, that, to
guard against its discovery before I should be safely away
from the shop, I placed it nearer the bottom than the top
of the pile.

That the letter which I thus successfully started on its
errand finally reached the Governor was not surprising. On

A MIND THAT FOUND ITSELF

igg

the back of the wrapper I had endorsed the following
words :

“Mr. Postmaster: This package is unsealed. Neverthe¬
less it is first-class matter. Everything I write is necessa¬
rily first class. I have affixed two two-cent stamps. If extra
postage is needed you will do the Governor a favor if you
will put the extra postage on. Or affix “due” stamps, and
let the Governor pay his own bills, as he can well afford to.
If you want to know who I am, just ask his Excellency, and
oblige, Yours truly,

?”

Flanking this notice, I had arrayed other forceful senti¬
ments, as follows — taken from statutes which I had framed
for the occasion:

“Any person finding letter or package — duly stamped
and addressed — must mail same as said letter or package
is really in hands of the Government the moment the stamp
is affixed.”

And again,

“Failure to comply with Federal Statute which forbids
any one except addressee to open a letter — renders one
liable to imprisonment in State Prison.”

One of the owners of the store in which I left this letter
found and mailed it. From him, I afterwards learned that
my unique instructions had piqued his curiosity, as well as
compelled my wished-for action. Assuming that the reader’s
curiosity may likewise have been piqued, I shall quote cer¬
tain passages from this four thousand word epistle of pro¬
test. The opening sentence read as follows : “ If you have had
the courage to read the above (referring to an unconventional
heading) I hope you will read on to the end of this epistle
— thereby displaying real Christian fortitude and learning a
few facts which I think should be brought to your attention.”

200

A MIND THAT FOUND ITSELF

I then introduced myself, touching upon my ancestry, and
proceeded as follows: “I take pleasure in informing you
that I am in the Crazy Business and am holding my job
down with ease and a fair degree of grace. Being in the
Crazy Business, I understand certain phases of the business
about which you know nothing.” (Apparently this was
meant to imply that the Governor himself was not “crazy.”)
“You as Governor are at present ‘head devil’ in this ‘hell,’
though I know you are unconsciously acting as ‘His
Majesty’s’ ist Lieutenant.”

I then launched into my arraignment of the treatment of
the insane. The method, I declared, was “wrong from
start to finish. The abuses existing here exist in every
other institution of the kind in the country. They are all
alike — though some of them are of course worse than others.
Hell is hell the world over, and I might also add that hell
is only a great big bunch of disagreeable details anyway.
That’s all an Insane Asylum is. If you don’t believe it,
just go crazy and take up your abode here. In writing this
letter I am laboring under no mental excitement. I am no
longer subjected to the abuses about which I complain. I
am well and happy. In fact I never was so happy as I am
now. Whether I am in perfect mental health or not, I shall
leave for you to decide. If I am insane to-day I hope I may
never recover my Reason.”

My arraignment began with the private institution where
I had been strait- jacketed. I referred to my oppressor

as “ p)r. - M.D. (Mentally Deranged).” Then followed

an account of my strait- jacket experience; then an account
of abuses at the State Hospital. I described in detail the
most brutal assault that fell to my lot. In summing up I
said, “The attendants claimed next day that I had called
them certain names. Maybe I did — though I don’t be-

A MIND THAT FOUND ITSELF

201

lieve I did at all. What of it? This is no young ladies’
boarding school. Should a man be nearly killed because he
swears at attendants who swear like pirates ? I have seen
at least fifteen men, many of them mental and physical
wrecks, assaulted just as brutally as I was, and usually with¬
out a cause. I know that men’s lives have been shortened
by these brutal assaults. And that is only a polite way of
saying that murder has been committed here.” Turning
next to the matter of the women’s wards I said: “A patient
in this ward, — a man in his right mind, who leaves here on
Tuesday next — told me that a woman patient told him that
she had seen many a helpless woman dragged along the floor
by her hair, and had also seen them choked by attendants
who used a wet towel as a sort of garrote.1 I have been
through the mill and believe every word of the abuse. You
will perhaps doubt it, as it seems impossible. Bear in mind,
though, that everything bad and disagreeable is possible in
an Insane Asylum.”

I must pause to call the reader’s attention to the degree
of fair-mindedness displayed in the foregoing. Facts I
stated as facts, but I was wise enough to qualify a state¬
ment incapable of proof. An extravagant imagination does
not necessarily supersede and suspend judgment.

When I came to the matter of the “Bull Pen” I wasted
no words: “The Bull Pen,” I wrote, “is a pocket edition of
the New York Stock Exchange during a panic.”

I next pointed out the difficulties a patient must over¬
come in mailing letters: “It is impossible for any one to
send a letter to you via the office. The letter would be con-

1 The records of several “legislative investigations,” which I have read,
show that untrained attendants, perhaps because they are unskilled and
uncertain of their power to control refractory patients except by force
seem prone to resort to the use of a towel as a sort of garrote.

202

A MIND THAT FOUND ITSELF

signed to the waste-basket — unless it was a particularly
crazy letter — in which case it might reach you, as you would
then pay no attention to it. But a sane letter, and a true
letter, telling about the abuses which exist here would stand
no show of being mailed. The way in which mail is tam¬
pered with by the medical staff is contemptible.”

I then described my stratagem in mailing my letter to the
Governor. Discovering that I had left a page of my episto¬
lary booklet blank, I drew upon it a copy of Rembrandt’s
Anatomy Lesson, and under it wrote: “This page was
skipped by mistake. Had to fight fifty-three days to get
writing-paper and I hate to waste any space — hence the
masterpiece, — drawn in five minutes. Never drew a line
till September 26 (last) and never took lessons in my life.
I think you will readily believe my statement.” I ask the
reader to notice here the humorous insight into my artistic
limitations which I displayed, despite my delusional state
of mind. Continuing in the same half-deluded, half-banter¬
ing vein, I said: “I intend to immortalize all members of
medical staff of State Hospital for Insane — when I illus¬
trate my Inferno, which, when written, will make Dante’s
Divine Comedy look like a French Farce.”

I then outlined my plans for reform: “Whether my sug¬
gestions meet with approval or not,” I wrote, “will not affect
the result — though opposition on your part would perhaps
delay reforms. I have decided to devote the next few years
of my life to correcting abuses now in existence in every
asylum in this country. I know how these abuses can be
corrected and I intend — later on, when I understand the
subject better — to draw up a Bill of Rights for the Insane.
Every State in the Union will pass it, because it will be
founded on the Golden Rule. I am desirous of having the
co-operation of the Governor of Connecticut, but if my plans

A MIND THAT FOUND ITSELF

203

do not appeal to him I shall deal directly with his only supe¬
rior, the President of the United States. When Theodore
Roosevelt hears my story his blood will boil. I would write
to him now, but I am afraid he would jump in and correct
abuses too quickly. And by doing it too quickly too little
good would be accomplished.” The reader will here per¬
haps infer ( and rightly) that my fear of hasty executive
action was really born of a desire to have a hand in the
crusade, and I knew that this would be impossible until I
should have regained my freedom.

Waxing crafty, yet, as I believed, writing truth, I con¬
tinued: “I need money badly, and if I cared to, I could
sell my information and services to the New York World or
New York J ournal for a large amount. But I do not intend to
advertise Connecticut as a Hell-hole of Iniquity, Insanity,
and Injustice. If the facts appeared in the public press at
this time, Connecticut would lose caste with her sister States.
And they would profit by Connecticut’s disgrace and cor¬
rect the abuses before they could be put on the rack. As
these conditions prevail throughout the country, there is no
reason why Connecticut should get all the abuse and criti¬
cism which would follow any such revelation of disgusting
abuse; such inhuman treatment of human wrecks. If pub^
licity is necessary to force you to act — and I am sure it will
not be necessary — I shall apply for a writ of habeas corpus,
and, in proving my sanity to a jury, I shall incidentally
prove your own incompetence. Permitting such a whirl¬
wind reformer to drag Connecticut’s disgrace into open
court would prove your incompetence.”

For several obvious reasons it is well that I did not at that
time attempt to convince a jury that I was mentally sound.
The mere outlining of my ambitious scheme for reform would
have caused my immediate return to the asylum. For all

204

A MIND THAT FOUND ITSELF

that, the scheme itself, stripped of its insane trappings, was
then, as it is to-day, absolutely feasible and sane; and, in
this assertion, I am supported by the opinions of certain
alienists who have read my story. According to these
authorities, my consistent and persistent desire to effect re¬
forms, taken by itself, was not characteristic of any form of
mental disorder. It was a sane idea; but, taking hold of
me, as it did, while my imagination was at white heat, I was
impelled to attack my problem with compromising energy
and, for a time, in a manner so unconvincing as to obscure
the essential sanity of my cherished purpose.

I closed my letter as follows: “No doubt you will con¬
sider certain parts of this letter rather ‘fresh.’ I apologize
for any such passages now, but, as I have an Insane License,
I do not hesitate to say what I think. What’s the use when
one is caged like a criminal?”

“P. S. This letter is a confidential one — and is to be
returned to the writer upon demand.”

The letter was eventually forwarded to my conservator
and is now in my possession.

As a result of my protest the Governor immediately
interrogated the superintendent of the institution where
“ Jekyll-Hyde” had tortured me. Until he laid before the
superintendent my charges against his assistant, the doctor in
authority had not even suspected that I had been tortured.
This superintendent took pride in his institution. He was
sensitive to criticism and it was natural that he should
strive to palliate the offense of his subordinate. He said
that I was a most troublesome patient, which was, indeed,
the truth; for I had always a way of my own for doing
the things that worried those in charge of me. In a word,
I brought to bear upon the situation what I have previously
referred to as “an uncanny admixture of sanity.”

A MIND THAT FOUND ITSELF

205

The Governor did not meet the assistant physician who
had maltreated me. The reprimand, if there was to be any,
was left to the superintendent to administer.

In my letter to the Governor I had laid more stress upon the
abuses to which I had been subjected at this private institu¬
tion than I had upon conditions at the State Hospital. This
may have had some effect on the action he took, or rather
failed to take. At any rate, as to the State Hospital, no
action was taken. Not even a word of warning was sent to
the officials, as I know, for before leaving the institution
I asked the doctors. It seems to me that the Governor
was derelict in his duty. If my letter was convincing
enough to induce him to inquire into a private institution,
surely he should have been equally willing to investigate
charges affecting the institution of which he was the nominal
head. The least that he could have done would have been
to convince himself that my charges were untrue.

Governors, for selfish or political reasons, are only too
willing to avoid the inevitable political scandal which follows
nine out of ten investigations of institutions politically organ¬
ized. Instead of humanely considering the just claims of
the State’s unfortunates, men in such positions of power too
often turn a deaf ear to the cries of the helpless. It is trite
to observe that the average politician (and most governors
are such) mistakenly thinks he must have one deaf ear
which he may interpose between himself and the call of
duty, while his supposedly “good” car is reserved for the
bad advice of better politicians than himself.

I am far from saying that the Governor in question delib¬
erately suppressed an investigation which his conscience
dictated. I have good reason to believe that he thought an
investigation would produce no results of value. Hc^kncw
that, on the whole, the State Hospital was fairly well managed

206

A MIND THAT FOUND ITSELF

— or at least better managed than similar institutions in many
other States. Further, he knew that the doctors in charge
were reputable men, and that, if they could not correct
abuses, a new medical staff would not be likely to do so
either. Considering the deplorable yet excusable ignorance
that prevails in reference to the treatment of insanity and
the proper management of institutions for the insane, the
action of the Governor was logical and, without doubt,
honest. In fact, I question whether one Governor in ten
in this country to-day has ever heard the word “Non-Re¬
straint,” — much less understands that a thorough enforcement
of its principles will eliminate a majority of existing abuses.

Though my letter did not bring about an investigation it
was not altogether without fruit. Naturally, it was with
considerable satisfaction that I informed the doctors that I
had outwitted them in their endeavor to keep me in exile;
and it was with even greater satisfaction that I now saw those
in authority make a determined, if temporary, effort to pro¬
tect helpless patients against the cruelty of attendants. The
moment the doctors were convinced that I had gone over
their heads and had sent a characteristic letter of protest to
the Governor of the State, that moment they began to pro¬
tect themselves with an energy born of a realization of their
former shortcomings. Whether or not the management in
question will admit that their unwonted activity was due to
my coup, the fact remains that the summary discharge of
several attendants accused and proved guilty of brutality
immediately followed, and, for a while, put a stop to wanton
assaults against which, for a period of four months, I had
protested in vain. This I know, for certain inmates of the
violent ward told me that comparative peace reigned about

A MIND THAT FOUND ITSELF

207

this time. That attendants can be scared into humanity, is
proved by a remark made to me by one the very day he had
been discharged for choking a patient into an insensibility so
profound that it had been necessary to call a physician to
restore him. Said this brute: “It seems to me they’re get¬
ting pretty damned strict these days, discharging an attendant
for simply choking a patient.” This discharged and guilty
attendant immediately secured a position in another hospital
of the same character in a city not twenty miles distant.

XXV

My failure to force the Governor to investigate conditions
at the State Hospital convinced me that I could not hope to
prosecute my reforms until I should have regained my lib¬
erty and re-established myself in my old world. I there¬
fore quitted the role of reformer-militant; and, but for an
occasional outburst of righteous indignation at some fla¬
grant abuse which obtruded itself upon my notice, my
demeanor was that of one quite content with his lot in life.

I was indeed content — I was happy. Knowing that I
should soon regain my freedom, I found it easy to forgive
— taking great pains not to forget — any injustice which had
been done me. Liberty is sweet, even to one whose appreci¬
ation of it has never been augmented by its temporary loss.
The pleasurable emotions which my impending liberation
aroused within me served to soften my speech and render
me more tractable. This change the assistant physician was
not slow to note, though he was rather slow in placing in
me that degree of confidence which I felt that I deserved.
So justifiable, however, was his suspicion that even at the
time I forgave him for it. I had on so many prior occasions
“played possum ’’that the doctor naturally attributed complex
and unfathomable motives to my most innocent acts. For a
long time he entertained the idea that I was trying to capture
his confidence, win the privilege of an unlimited parole, and
so effect my escape from the institution. He had doubt¬
less not forgotten the several plans of escape which I had
toyed with and bragged about while in the violent ward.

20S

A MIND THAT FOUND ITSELF

209

Though I was granted considerable liberty during the
months of April, May, and June, 1903, not until July did I
enjoy a so-called “unlimited parole” which enabled me to
walk about the neighboring city unattended. My privi¬
leges were granted so gradually that these first tastes of re¬
gained freedom, though delightful, were not so thrilling as
one might imagine. I took everything as a matter of course,
and, except when I deliberately analyzed my feelings, was
scarcely conscious of my former deprivations.

This power to forget the past — or recall it only at will —
has contributed much to my happiness. A majority of
those who have suffered experiences such as mine are prone
to brood upon them, and I cannot but attribute my happy
immunity from unpleasant memories to the fact that I
have viewed my own case much as a physician might
view that of a patient. My past is a thing apart. I can
examine this or that phase of it in the clarifying and
comforting light of reason. I can, as it were, hold my past
in my hand and analyze its complex and bewildering collec¬
tion of thoughts under a memory rendered microscopic.
And I am further comforted by the belief that I have a dis¬
tinct mission in life a chance for usefulness which might ’
never have been mine had I enjoyed unbroken health.

The last few months of my life in the hospital were much
alike, save that each succeeding one brought with it an
increased degree of liberty. My hours now passed pleas¬
antly. Time did not drag, for I was engaged upon some
matter, every minute. I would draw, read, write, and talk.

If any feeling was dominant it was my feeling for art; and,
had I then been forced to choose irrevocably a life-work, I
should have decided in favor of the study of art. I read
with avidity books on that subject. In fact, I have never
read any books with greater interest than these, which, to-

210

A MIND THAT FOUND ITSELF

day, interest me scarcely at all. For, strange as it may seem,
the moment I again found myself in the world of business
my desire to become an artist died almost as suddenly as it
had been born. Though my artistic ambition was clearly
an outgrowth of my abnormal condition, and languished
when normality asserted itself, I am inclined to believe I
should even now take a lively interest in the study of art if
I were so situated as to be deprived of a free choice of my
mode of life. The use of words now enthralls me because
it is eminently suited to my purposes; and its mere utility
is re-enforced by a perhaps instinctive though long-latent
desire for expression.

During the summer of 1903, friends and relatives often
called to see me. The talks we had were of great and last¬
ing benefit to me. Though I had rid myself of my more
extravagant and impossible delusions of grandeur flying
machines and the like — I still discussed with intense ear¬
nestness other schemes, which, though allied to delusions
of grandeur, were, in truth, still more closely allied to san¬
ity itself. My talk was of that high but perhaps suspi¬
cious type in which Imagination overrules Common Sense.
Lingering delusions, as it were, made great projects seem
easy. That they were at least feasible under certain condi¬
tions my mentors admitted. Only I was in an insane hurry
to produce results. Work that I now understand cannot
be accomplished in less than five or ten years, if, indeed, in
a life-time, I then believed could be accomplished in a
year or two, and by me single-handed. Had I had none
but insane persons to talk with I might have continued to
cherish a distorted perspective. As it was, the unanimity
of sane opinions helped me to correct my views; and I am
confident that each talk with relatives and friends hastened
my return to normality.

A MIND THAT FOUND ITSELF

21 1

Though I was not discharged from the State Hospital until
September ioth, 1903, during the preceding month I visited
my home several times, once for three days. These trips
were not only interesting but steadying in their effect. I
willingly returned to the hospital for the remaining days of
my confinement. Though several friends expressed sur¬
prise at this willingness to enter again an institution where
I had experienced so many hardships, to me my temporary
return was not in the least irksome. As I had penetrated
and conquered the mysteries of that dark side of life, it no
longer held any terrors for me. Nor does it to this day. I
can contemplate the future with a greater degree of com¬
placency than can those whose lot in life has been uniformly
fortunate. In fact, I said at that time that, should my con¬
dition ever demand it, I would again enter a hospital for the
insane, quite as willingly as the average person now enters
a general hospital for the treatment of a bodily ailment.

It was in this complacent and confident mood, and with¬
out any sharp line of transition, that I again began life in
my old world of companionship and of business.

PART II

XXVI

After again becoming a free man, my mind would not
abandon the miserable ones whom I had left behind. I
thought with horror that my reason had been threatened
and baffled at every turn. Without malice toward those
who had had me in charge, I yet looked with contempt
upon the system by which I had been treated.

The word “hospital” should be one of the most comfort¬
ing in the language. Yet I know that probably in every
State in the Union men and women on the verge of collapse
have killed themselves to escape commitment — and
others, having survived confinement, have deliberately
chosen death rather than re-commitment. As a patient, in
my hearing, once remarked: “I’d rather be hung than killed
an inch at a time.” This thought was more forcefully ex¬
pressed by an ex-patient whose case was brought to my at¬
tention by the Kentucky lawyer-attendant already referred
to. He had been temporarily cured, but seemed threatened
with a return of his malady. Divining the secret purpose of
his relatives to return him to an asylum, where he had for¬
merly been terribly abused, he shot himself through the heart.
A message left by this victim of public indifference, or (shall
I say?) ignorance, read as follows:

“I’d rather die than go back there.”

Only within about twenty years has the public . taken
kindly even to “general” hospitals, and only within the
last decade have hospitals for the insane begun to lose their

212

A MIND THAT FOUND ITSELF

213

forbidding suggestiveness. Even to-day they are almost uni¬
versally regarded with dread. Why? Partly because of
man’s instinctive dread of insanity itself; but quite as much,
I think, because of the terrifying air of mystery which
for generations has enshrouded these institutions. This
air of mystery, fostered by the secretive conduct of our
asylums, has been perpetuated and, indeed, in a large de¬
gree, cieated, by rumors and occasional proof of abuses
appearing now and then in the public print. Thus it
is that the shortcomings of the State itself often force a
desperately despondent man to take that life which it is the
duty of the State to protect. For these avoidable suicides
we cannot, however, wholly blame the present manage¬
ments of our existing hospitals. They are partly the re¬
sult of that dread of insanity and asylums which has been
bequeathed to us by past centuries — a dread that will
continue to force men to a self-inflicted death until a univer¬
sal confidence in such hospitals, and a rational view of
insanity itself, shall obtain.

XXVII

I have authority for the statement that there is no specific
for insanity or for any phase or type thereof. For the most
part, all that any system of treatment can hope to clo is to
give nature a chance to right itself by surrounding the pa¬
tient with the best possible conditions. Yet, in most
instances, this is precisely what is not done.

What then are some of the causes for this state of things,
and what are some of the remedies ? Of improved sanitary
equipment I shall speak later. Here let me speak at length
only of food and of dining facilities.

During the past century the insane, as a class, have per¬
haps been the poorest fed. Not many generations ago it
was universally the custom to feed them on veritable husks,
scarce fit for swine. In some communities to-day they have
to be content with the coarsest food, frequently of such qual¬
ity that a sane person would refuse to eat it. Attendants,
whose fare is little, if any better, can testify to this fact. Indeed
they do occasionally testify forcefully by threatening to stop
work unless the management improve the quality of their
rations. Such protests are usually effective. But what can
patients do to emphasize their protest? Nothing, except
to stop eating — a course which many of them take from
time to time, until the instinct of self-preservation overcomes
their eminently sane disgust.

Though there arc to-day in this country comparatively
few institutions where patients and attendants are fed as
well as they deserve, it is my opinion that the several man-

214

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2I5

agements are entitled to considerable credit for the great
improvement that has been made in this particular depart¬
ment during the past score of years. In many institutions
an honest attempt is being made to provide nothing but
wholesome food. Unfortunately it is equally true that in
some institutions dishonest officials consider the happiness
of their charges of so little moment that for a few mean dol¬
lars they will barter it away according to the rules of that
discredited political game, “Graft.” Whenever and wher¬
ever the members of a medical or executive staff of a hospital
for the insane are dependent upon a political party or polit¬
ical “boss” for their continuance in office, you will be apt
to find in operation a pernicious system of perquisites which
can be wrung from the State’s appropriations only at the
expense of the inmates of the hospitals. This “graft, ” which
first strikes at the consciences of the men in authority, at one
and the same time strikes the inmates in that most vulnerable
spot — the stomach. Each and every state-appropriated
dollar that is diverted by a dishonest manager or manage¬
ment means just so much less comfort for the inmates, who
already suffer unnecessary hardships because of inadequate
appropriations. The quality and quantity of food provided
is sure to be adversely affected. Usually it is the purchasing
of supplies which affords the only sure opportunity for
“graft,” and as a major part of the appropriations must be
spent for food, dishonesty, where it exists, affects vitally the
well-being of the patients. To the mind of every right-
thinking person, the political “grafter,” who will wring
his mean gains from the very blood of the most unfortunate,
is a man deserving of discovery and its consequent disgrace
and punishment. I predict that honest legislative investiga¬
tions will uncover many miserable specimens of humanity
who for years have fattened by the emaciation of misery itself.

2l6

A MIND THAT FOUND ITSELF

In arguing for a right quantity and quality of food I do
not mean that a State should be expected to provide a great
variety. At this stage of hospital development that is of
course impossible. But at least an illusion of variety might
be created if the menus were not decided upon months in
advance. To know that certain articles of food will appear
on a certain day of the week, each week, each month, is to
rob a patient of that element of surprise which in itself
serves as an appetizer.

During the first six months of my confinement at the State
Hospital, though I finally grew tired of the food provided
and had difficulty in swallowing enough of it to satisfy
hunger, the most serious fault I had to find with it was with
respect to its quantity. Not until I was admitted to the
common dining-room of the ward was I able to satisfy my
hunger. Then, for nearly a month — this after two months
of eating in comparative solitude — I ate two, sometimes
three, of the regular portions at each meal. This was not
gluttony — lack of variety, if nothing else, protected me
against sinful indulgence. It was occasioned by an instinc¬
tive desire to repair the damage done dining my period of
“seclusion.” That my loss in weight already referred to was
occasioned more by privation than by my state of mind, or
the abuse to which I was subjected, is borne out by an earlier
experience; for during my strait-jacket ordeal at the private
hospital I was given nourishing food at frequent intervals
and I left the padded cell weighing nearly as much as the
day I first entered it.

A majority of patients to-day are fed in small dining-rooms
connected with the ward in which they happen to be con¬
fined. The food is sent from the main kitchen to these
centers of distribution and there apportioned and served by
attendants. The attendants arc supposed to allow the

A MIND THAT FOUND ITSELF

217

patients a sufficient time to eat their meal, but it frequently
happens that certain ones have not finished eating when the
attendant in charge says: “All up!” In a violent ward, and
sometimes in others, any patient who fails to obey that com¬
mand invites abuse. More than once have I seen a patient
forced to leave a half-eaten meal and quit the room — or
perhaps be forcibly ejected; and I myself have often pru¬
dently stowed away in a hurry an adequate amount of food
within an uncertain and arbitrarily limited time. One of
the most revolting and least justifiable assaults I ever wit¬
nessed occurred in the dining-room of the violent ward at
the State Hospital. When the patient had been kicked and
choked into a state bordering on insensibility the attendants
calmly, but breathlessly, returned to their own meal. I shud¬
der when I think of the punishment that would have been
mine had circumstances forced me to enter a violent ward
during that stage of my illness which was characterized by a
continued refusal to eat what was placed before me — ex¬
cept when my inscrutable impulses directed otherwise. It is
my conviction that this book would never have been written
had not a “timely generosity” kept me from such abuse
while mute and crippled.

But in a hospital which has that modern improvement
known as an associate dining-hall, such abuses as I have
described cannot affect a majority of the patients. The
State Hospital in which I was confined, now has as good a
dining-hall of this type as any in the country; and its out-
lying groups of buildings have smaller ones. This associate
or “congregate” dining-hall was first used about three months
before I was discharged; consequently I am in a position to
contrast its advantages with the shortcomings of the ward
dining-rooms. The associate hall in question had a seating
capacity of twelve hundred. This fact in itself is perhaps

2l8

A MIND THAT FOUND ITSELF

surprising, for most people picture an asylum for the insane
as a place of great disorder, if not riot. Yet day after day,
twelve hundred insane men and women here gather and
partake of the indifferent, though wholesome and life-sus¬
taining, food provided by the State. And this, too, with
relatively less disorder than will be found among an equal
number of undergraduates at any of our great universities
where similar dining-halls are in operation.

In an associate dining-room, under the eyes of one or more
of the assistant physicians, the solicitous consideration for
his charges on the part of the brutal type of attendant is
positively refreshing, even if inspired by the motive of self-
interest. Aside from the personal safety of the patient
which thus results, there are many other advantages. The
patient is sure to get a sufficient amount of food and an ample
allowance of time in which to eat it. Usually an hour is
allowed for each meal — that time including the walking
to and from the dining-hall. In this way the inmates are
able to while away three hours of the long day. At noon
and night an orchestra enlivens the meal. That this music
has much to do with the good order that obtains is an ad¬
mitted fact, for it has been proved that music is an excel¬
lent medicine for the mentally disturbed. It is to be
regretted that the associate dining hall does not utterly
eliminate the abuses which exist in so many wards. Un¬
fortunately only those able to take some care of themselves
are permitted to enjoy its advantages. Those most in need
of protection are still left to the uncertain ministrations of
unwatched attendants.

XXVIII

Worse than the negligent treatment of the body is a vexa¬
tious treatment of the mind itself. I have already made it
clear that unjustifiable interference with the mail-matter of
the patient is a common practice. This may be aptly desig¬
nated as the major petty abuse of that multitude of petty
abuses which help to make the lot of the insane so hard.

Next to the instinctive desire for freedom, which naturally
inspires almost every inmate of an asylum, perhaps the
commonest desire is to be allowed to write and receive letters
as he had been accustomed to do before his commitment.
This gives rise to the universal bone of contention on which
doctors and patients chew — yes, and over which they growl
and snarl. Every day in the year, year in and year out, in
the majority of such institutions, this battle is waged. The
patients chafe under censorship, let alone confiscation.

In the main they are right. It is without question unjust,
as it is, indeed, illegal, that a patient should be denied the
privilege of communicating, almost at will, with at least his
legally appointed conservator. Yet doctors of the despot
type do censor and frequently destroy letters, — except in
those rare instances when a patient writes a string of silly
nothings, or speaks in complimentary terms of the institu¬
tion and its management. But missives of the latter sort
are naturally rare — and will continue to be so until the sev¬
eral managements begin to inspire encomiums by deserving
them. The elimination of this one abuse would go far to
eliminate others which grow out of it. On the other

2IQ

220

A MIND THAT FOUND ITSELF

hand, when the physical and allied abuses shall have been
done away with, there will be less temptation to interfere
with patients’ correspondence; for, the moment patients are
universally treated with consideration they will be pretty
likely to declare that fact in their letters. Then, not only
will the doctors in authority not censor and wantonly destroy
these letters — they will exert themselves to keep patients in
close and honest touch with their relatives and friends.

I, perhaps, feel more strongly on this subject than on
almost any other. I know what it is to be kept in an exile so
complete that I could not send a message of any sort to my
legally appointed conservator — my own brother; and that,
too, at a time when I greatly desired to ask him for assist¬
ance in my fight against abuse and positive danger. This
situation occurred first at the private hospital where I was
strait- jacketed for three weeks. Within a month of its first
occurrence it occurred again at the State Hospital. Indeed,
so long as I wrote letters at these two institutions, except for
a short initial period at each, I never felt sure that my let¬
ters were not being held or destroyed by the doctors in
authority, — and with reason. My letters were on several
occasions confiscated — letters, too, which there was no
excuse for so treating, except that they contained nothing
but the truth. Though many of my letters were finally
forwarded to my conservator, in a few conspicuous instances
they were destroyed without the knowledge of either my
conservator or myself. I have already described how an
assistant physician arbitrarily denied my request that I be
permitted to send a birthday letter to my father, thereby not
merely exceeding his authority and ignoring decency, but,
consciously or unconsciously, stilling a sane impulse, d hat
this should occur while I was confined in the Bull Pen was
not so surprising. But, about four months later, while I

A MIND THAT FOUND ITSELF

221

was an inmate of one of the best wards, a similar though
less open interference occurred. At this time I was so
nearly normal that my discharge was but a question of a few
months. Anticipating my return to my old world I decided
to begin the re-establishment of old relations. Accordingly,
my brother, at my suggestion, informed certain friends that
I should be pleased to receive letters from them. They soon
wrote. In the meantime the doctor had been instructed to
deliver to me any and all letters that might arrive. He did
so for a time, and that without censoring. As was to be ex¬
pected, after nearly three practically letterless years, I found
rare delight in replying to my re-awakened correspondents.
Yet some of these letters, written for the deliberate purpose
of re-establishing myself in the sane world, were destroyed by
the doctor in authority. At the time, not one word did he
say to me about the matter. I had handed him for mailing
certain letters, unsealed. He did not mail them, nor did he
forward them to my conservator as he should have done,
and had earlier agreed to do with all letters which he
could not see his way clear to approve. It was fully a
month before I learned that my friends had not received my
replies to their letters. Then I accused the doctor of de¬
stroying them, and he, with belated frankness, admitted that
he had done so. He offered no better excuse for his action
than the mere statement that he did not approve of the sen¬
timents I had expressed. Another flagrant and typical in¬
stance of such interference was that of a letter addressed to
me in reply to one which I had mailed surreptitiously. The
person to whom I wrote, a friend of years’ standing, later
informed me that he had sent the reply. I never received
it. Neither did my conservator. Were it not that I feel
absolutely sure that the letter in question was received at
the hospital and destroyed, I should not now raise this point.

222

A MIND THAT FOUND ITSELF

But such a point, if raised at all, must of course be made
without that direct proof which can come only from the
man guilty of an act which in the sane world is regarded as
odious and criminal. If a crime in the sane world, surely
it is doubly a crime when its commission injures a person
already stripped of most of his privileges by the laws of
the State.

My experience in this respect was not exceptional. I
know in my own heart that during the past year thousands
of the inmates of our asylums have been subjected to like
unjust treatment, and during the past century, tens of thou¬
sands. At this very moment many patients quite
capable of writing fairly lucid, even sane, letters, are, for
any one of a number of reasons, kept out of touch
with relatives and friends. These sympathizers would
gladly keep in closer touch with the afflicted ones, if they
were advised to do so by the hospital authorities. But,
instead of encouraging such beneficial intercourse, doctors,
with few exceptions, at least tacitly discourage it. Occa¬
sionally those in authority frankly advise against it. When
such advice is given the doctors explain at plausible length
that the receiving and reading of messages from home tends
to excite the patient — especially when the patient first enters
an institution. To my mind this procedure is wrong. It
is, indeed, worse than an error of judgment. It is a posi¬
tive cruelty. The patient when committed has enough to
contend against without being forced to fight for his life and
liberty unsupported by messages from those he loves — or,
for that matter, even temporarily hates. The first weeks of
exile arc the ones which determine the patient’s attitude
toward his new and distressing environment. If to a pa¬
tient’s sense of loneliness there be added the suspicion or
belief that his relatives and friends have forsaken him, does

A MIND THAT FOUND ITSELF

223

it not stand to reason that his recovery will be retarded, if,
indeed, the consequent dejection does not forever render
recovery impossible?

I do not exaggerate when I say that this interference with
a privilege which is part of the birthright of every American
citizen causes more anguish among the insane than physical
abuse. One can suffer an incredible amount of physical
abuse, and forget and forgive. But the opening and illegal
confiscating of letters is nothing short of dishonorable in
the eyes of men and women brought up to respect the
sealed messages of others. The moment a patient proves
to himself — and the proof is seldom wanting — that his
mail is being tampered with, that moment he loses all confi¬
dence in the doctors. As insanity itself in a majority of
cases is characterized by an inordinate suspicion of others,
is it sensible or scientific for a management to forever under¬
mine the very grounds of belief that must be established if a
recovery is to be hastened, or ever secured ?

I will admit that there may be an occasional instance
where messages from home might prove detrimental, but
such cases are so rare as to justify my contention that every
patient, from the moment of commitment, should be allowed
a high degree of liberty in the matter of correspondence.
His letters, both incoming and outgoing, should not be sub¬
jected to the scrutiny of officials whose burdensome duties
so often render impossible anything like a fair inspection of
the patients’ mail. Indeed, the only type of physician that
deserves to be invested with powers of censorship is that, I
regret to say, rare type of man who is so interested in his
work that he desires to read letters for the purpose of judg¬
ing, with scientific precision, a patient’s state of mind at a
given time. Without question, written thoughts furnish an
invaluable basis for diagnosis, and to deprive a high-minded

2 24

A MIND THAT FOUND ITSELF

psychiatrist of the privilege of scientific scrutiny of mail-
matter — which term I use in contradistinction to scrutiny
of the more common, self-protecting sort condemned —
would no doubt work an injustice to all concerned. Never¬
theless, in view of the fact that comparatively few physicians
working among the insane seem able to censor mail in the
right rather than the wrong spirit, I feel safe in recommend¬
ing that a letter written by a patient should be sent without
censoring, or not be sent at all. Inasmuch as a psychia¬
trist genuinely interested in the welfare of a given patient
will, perforce, be on the best of terms with his conservator,
and, in most instances, with the patient himself, it will be an
easy matter for him to secure copies of a patient’s letters —
or the originals — simply by stating his reasons to the con¬
servator and asking for what he wants. In this way, free¬
dom of communication with the outside world may be main¬
tained and the interests of the patient — and physician —
conserved. In contending that letters written by a patient
should be forwarded unopened, unread, I do not mean that
the inmate of an asylum should be permitted to write to any
and all persons. For his own protection, and the protection
of the public, he should be allowed to write only to those des¬
ignated by the persons who effect his commitment, provided
the list contain at least one other name besides that of his
appointed conservator. This second person should be one
who is interested in the welfare of the patient, for it fre¬
quently happens that the legally appointed conservator is
derelict in his duty. A committed person should be per¬
mitted to write at will to his conservator, and to the one
other person selected by himself — or selected for him,
should he himself express no choice. In addition to these
two persons, as many other relatives and friends should be
placed on the list as the conservator may see fit to designate.

A MIND THAT FOUND ITSELF

225

Such an arrangement would relieve the doctors both of work
and of responsibility. Instead of censoring every letter, as
they now feel called upon to do, they would need only to
satisfy themselves that a patient’s letter was addressed to
some one of his authorized correspondents.1

An objection which the doctors have in the past enter¬
tained toward this suggestion is that the patient will perhaps
use improper language in his letters. It cannot be denied
that in every such hospital there are always a few patients
whose condition of mind will impel them to write with a
brutal frankness likely to offend the taste of the fastidious.
The fact is, however, that there are no patients at any time
in any hospital whose letters will seriously offend the sensi¬
bilities of the two or three selected representatives whose
bounden duty it is to share the afflicted one’s burden.
Surely a patient’s letters need not distress his relatives and
friends more than his unwilling silence. Further, let such
relatives and friends ask themselves whether they would
rather be obliged to read or, alas! to write such letters.

Those patients whose mental disease is of a form charac¬
terized by prevarication — a kind not common — will soon
prove the fact in their letters. After that fact has been
proved the recipients of the letters will be able to judge their
contents and act accordingly. Such lies can do no one harm,
and the mere telling of them may, perhaps, do the patient
good. It seems to be an almost universal belief that the
statements of insane persons are to be regarded with a de¬
gree of suspicion that amounts to disbelief. On this point

1 In some States the law provides that a patient may write to designated
tate officials and that such letters shall be forwarded, uncensored. As far
as it goes it is a good law. But how far does it go ? Would it not be better to
put and keep the patient in close and honest touch with relatives and friends
y a opting some such plan as I have ventured to suggest ? Blood is thicker
and warmer than the chilly waters of impersonal officialism.

l6

226

A MIND THAT FOUND ITSELF

I feel qualified to speak. Aside from delusions (which have
nothing to do with the question) there is, I am sure, not a
less degree of truth spoken among a given number of insane
persons than among a like number of sane persons indis¬
criminately selected. The insane, as a class, are the most
outspoken speakers of the truth to be found anywhere, in that
respect rivaling the proverbial child. Freed from the restrain¬
ing conventions of polite society, if they have an opinion to
offer they rid themselves of it without reserve. And it is this
very freedom of expression (aside from delusions) which, in
my opinion, puts the statement of the average insane person
on a par with the reserved, self-interested, and frequently
biased statements of the average sane member of society at
large. I argue with one thought in mind: that the inmates
of an asylum are, on the whole, as well qualified to tell the
truth regarding its abuses as the inhabitants of the sane
world are to describe abuses in their respective spheres of
activity.

As conditions now are, hundreds of these true accounts
of abuse are each year confiscated by those, directly or in¬
directly, guilty of it. And much that makes the lives of the
inmates so miserable has continued so long because of the
ease with which a careless, if not criminal, management may
cover its tracks. A due observance of the liberty of corre¬
spondence would go far to destroy this unjust immunity.
Physicians to-day often declare that their one thought in
controlling the correspondence of an insane charge is that
he may thus be kept in a calm and peaceful state of mind.
But their real motive is likely to be nothing more than a sel¬
fish — if not cowardly — desire to protect themselves
against well merited criticism by the public. Oftentimes
this self-protecting attitude of the medical staff may be traced
to the known but not openly expressed wish of a timid Board

A MIND THAT FOUND ITSELF

227

of Trustees, or to the wish of supposedly influential poli¬
ticians, who perhaps ask no more of the management of an
institution than that it shall so conduct affairs as to avoid
“investigations” or so-called “hospital scandals.” Thus
the sick insane are made to suffer, for no better reason,
apparently, than that certain sane persons in positions of
responsibility may escape annoyance.

What will put an end to this disgraceful state of affairs?
Many elaborate statutes would seem, on their face, to pro¬
tect patients against every imaginable abuse. Yet they fail,
and will continue to fail, until there is a militant public sen¬
timent of sufficient strength to coerce the several hospital
managements into a vigilant and considerate activity. The
lasting correction of evils lies with the public, therefore it
behooves each individual to contribute his word or deed to
the total effect.

XXIX

The central problem in the care of the insane is the
elimination of actual physical abuse. What I have nar¬
rated from my own experience and from the experiences
of others makes clear enough the nature of the average
attendant. Under a bad regime their baser natures grad¬
ually gain the mastery. Surprising as it may seem, many
an assault is due in the last analysis to a wanton desire to
satisfy what amounts to a craving for human blood. This
fact is well illustrated in the remark of an attendant, in the
Kentucky institution already referred to, who said, “When
I came here if any one had told me that I would be guilty
of striking a patient I would have called him crazy himself,
but now I take delight in punching hell out of them.”

What is responsible for the development of the brutal
attendant and his continued existence?

In the first place, not only do locks and bars protect men
mean enough to abuse the helpless, the sense of security
itself really inspires them to wicked deeds. And this feeling
of security is strengthened by the knowledge that chance
witnesses can but rarely testify convincingly in a court of
law. Being removed from the restraining influence of sane
eyes, the attendant does not fear to abuse, or (the vicious
type) even sometimes to kill a patient. At the worst he sees no
greater penalty in store for him than the loss of his position.
The chance of arrest and trial is so remote as to escape
consideration; and a trial has few terrors for such attend¬
ants as are arrested, for acquittal is almost certain. In

328

A MIND THAT FOUND ITSELF

229

deed, on those rare occasions when attendants happen to be
indicted for murder or manslaughter, the public generally
gives them the benefit of the doubt, assuming that their work
is highly dangerous, and arguing that the occasional sacrifice
of the life of an insane patient is unavoidable, therefore jus¬
tifiable. In this the public is in error, for, though the work
in question may be, and at times is, harassing, it is, by no
means, peculiarly hazardous. The number of unprovoked
attacks made upon attendants by insane patients is, in fact,
small, and would become almost negligible were all patients
treated kindly from the moment of commitment.

But can we put all the blame on attendants for assaulting
patients when the management shows no aggressive disposi¬
tion to protect the latter? Such indifference is far more
reprehensible than the cowardly conduct of ill-paid men, the
majority of whom have had few advantages of education.
The professional thug-attendant who, when a fellow-attend¬
ant is assaulting a patient, deliberately turns his back so
that he may say, if ever questioned, that he saw no assault,
is, in my opinion, less deserving of censure than those doc¬
tors who, knowing that brutality is common in their institu¬
tion, weakly resign themselves to what they call “conditions.”

Much of the suffering among the insane to-day is, in my
opinion, due to the giving of too much authority to assistant
physicians. Many of them, especially the young and inex¬
perienced, are not to be trusted implicitly. Or, if they are
to be given almost absolute authority over the patients in
wards assigned to their care, let the superintendent exercise
his authority to set aside any order which he may deem in¬
expedient or unjust. All superintendents have such author¬
ity. What I wish to emphasize is that they too often fail to

exercise it. As a result of their laxness, or timidity _ a

timidity perhaps inspired by a misconception of the ethics

230

A MIND THAT FOUND ITSELF

of their profession — the helpless patient is permitted un¬
necessarily to suffer; and, I regret to record, frequently is
this suffering of the patient due to what seems a selfish de¬
sire of the superintendent to preserve peace in his official
family — the medical staff. Official peace at such a price
amounts to crime.1

But quite as culpable as lax discipline is the selfish desire
on the part of doctors in authority to escape annoying inves¬
tigations. When it does happen that they cannot avoid
reporting felonious assaults or suspected murders to the
proper authorities, their action, I regret to say, is too often in
mere self-defense, and not from a righteous desire to protect
their patients. Knowing that the battered and mutilated
condition of the corpse, or a living victim of abuse, for that
matter, will arouse suspicion on the part of the relatives of
the victim, those in authority sometimes take the initiative
in order to “save their face.” In making this assertion I am
well within the bounds of charity and truth, and the conduct
of this type of doctor at the subsequent trial invariably is
such as to support my contention. This behavior is quite
human; for, let it be borne in mind that almost every honest
investigation into these suspicious deaths reveals a greater
or less degree — sometimes a criminal degree — of neglect
on the part of the doctors themselves. If cornered at last
by an aroused public opinion they are too ready to shift the
responsibility upon the ignorant and untrained attendants

1 Of course there is much to be said in favor of giving a high degree
of authority to an assistant physician, — provided his commanding officer,
the superintendent, be a man whose own standard of efficiency is so high
that he will, perforce, support his co-workers in their efforts to produce the
best results. Thus a young physician, instead of having, at the very begin-
ing of his career, all ambition and initiative ground out of him by that
sodden and fatal sort of hospital routine into which he is so often forced to
sink, will have an opportunity to develop into a man of capacity and in¬
creased usefulness.

A MIND THAT FOUND ITSELF

231

whose brutality is but the reflex of the doctors’ indifference,
neglect, or cowardice. But this is the last resort. Usually
they will first equivocate to the verge of deliberate false¬
hood. They will outrun the public by giving the benefit of
all doubts to the attendants. Not to do so would in many
cases cause the accused to turn on them and reveal condi¬
tions they would prefer to hide. Human nature, like Nature
herself, is influenced by immutable laws. Self-interest is apt
to kill one’s higher feelings. To fight the fight of the op¬
pressed, the outraged, the dead, too frequently forces one to
abandon a chosen career. Therefore, the still voice of a
timid conscience whispers (in a perverted sense): “Let the
dead bury their dead.”

I cannot lay too much stress on this absolute fact: that
hospital managements deliberately, wilfully, and selfishly
suppress evidence which, if presented to the proper author¬
ities, would lead to the conviction of guilty attendants, and
eventually to their almost complete elimination from asylums.
Several instances of such suppression have come to my
attention since my discharge, two of which I shall now cite.
During the summer of 1907, a Committee of Investigation
appointed by the Legislature of the State of New Jersey, un¬
covered, several months after the commission of the crime,
the suppressed evidence of the murder of a patient by at¬
tendants at the Trenton State Hospital. On the witness-
stand the hospital official in authority admitted that the
attendants had killed the patient and that their only punish¬
ment had been their prompt discharge as employees. He
further admitted that the “scandal” had been deliberately
suppressed, and that no evidence or report of the crime had
been submitted to the proper authorities as is, of course,
required by law. So skilfully was this crime concealed that
even the wife of the victim was unable to learn the cause of

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her husband’s death until the investigators laid bare the facts.
And this same Committee of Investigation uncovered an¬
other alleged and, to my mind, proved murder in another
State Hospital for the Insane — at Morris Plains, New Jer¬
sey. Here, again, the “scandal” (a hospital euphemism for
“murder” and lesser crimes) was “hushed-up” or “white¬
washed.” When it was finally dragged into the light of
day, what happened? Those in authority, making char¬
acteristic use of the ignorance of the public regarding such
matters, brazenly, I think, denied in sweeping terms, and
under oath, the incriminating evidence of supposedly cred¬
ible witnesses. If an investigation in New Jersey can re¬
veal two unreported murders that occurred within a year in
two State Hospitals, how many such crimes would be un¬
earthed should the two hundred and twenty-six public and
one hundred and two private hospitals for the insane in this
country be honestly investigated ? The probable figure is too
appalling to print.

Hospital managements (not only the doctors, but the
trustees as well) are too often cowardly bodies of men. They
shun publicity, and thereby sacrifice the well-being of their
unfortunate charges. If they would act promptly and rig¬
orously when abuse is even suspected, they would need have
no fear that the public would not support them. But, so
long as they continue to suppress facts which no good citizen
in the sane world would dare or wish to suppress, just so
long will they stand in danger of being dragged into a com¬
promising prominence by those reformers who, from time
to time, like Dorothea Lynde Dix, succeed in penetrating
the mysteries of their exclusive society. Nor can they surely
tell when and where the lightning of accusation will strike.
And if, instead of sporadic lightning, the steady glow of
enlightenment shall obtain, present incompetent scivants of

A MIND THAT FOUND ITSELF

233

the public will correct their costly faults, or be forced to
seek employment in other fields where their innate defi¬
ciencies will interfere with no one’s happiness but their own.

Inasmuch as hospitals for the insane are so often the
closest of “close corporations,” it is essential that investi¬
gators and the hospital officials (including Trustees or
Managers) should meet with an honest desire to improve
conditions permanently. They should not meet, as they
have done so often in the past, with the selfish desire to
“white-wash” and thus fool the public into believing con¬
ditions better than they are. Such reports of investigations
as I have read support my contention that members of the
medical staff of a hospital for the insane are prone to offer
excuses, rather than give reasons for such abuses as are
disclosed by the examining authority. And these excuses
are usually so plausible as to defeat, in many instances,
the purposes of an investigation. For generations, doctors
working among the insane have had to hide facts, until,
finally, convincing evasion of fact has become with them
an unconscious art. I do not mean to say that the officials
in question deliberately and habitually lie in order to deceive
the public. But I do say that, having for years been forced
by apathetic representatives of the public to work with
crude equipment and inadequate support, these men have
fallen into the weak habit of looking at problems of hos¬
pital administration from a disheartened and apologetic
point of view. Given a wrong point of view, the rest has
been very simple, for so few laymen know what earnest
and unremitting effort might accomplish in this field that
the plausible and veiled excuses of hospital officials are
commonly accepted as coin of full weight.

234

A MIND THAT FOUND ITSELF

Fortunately the securing of the whole truth does not de¬
pend upon skilful apologists — or upon those whose standard
of truth has been lowered by years of enforced shoulder¬
ing of the public’s shortcomings. In every improperly
conducted institution there will be found a few attendants,
both men and women, who at heart loathe the conditions
under which they are compelled to gain their livelihood.
These would welcome an opportunity to tell the truth and
help correct the evils which so offend their better natures.
The only incentive they need is a knowledge that the public
will support them in a course which, if pursued independ¬
ently, would probably be met with incredulity and could
result only in their discharge. It is mainly on such a
nucleus of witnesses that I rest my complete confidence in
the efficacy of any honestly conducted investigation.

In conspicuous instances the investigations will reveal a
satisfactory state of affairs. Fortunately there are a num¬
ber of institutions managed by men both honorable and
capable. Such managements have nothing to fear. In
fact, they will receive that credit which of right should
redound to those who, in the midst of unfavorable condi¬
tions, and in spite of a dormant public, have so nobly dis¬
charged their duty to the least safeguarded of the world s
unfortunates.

No doubt many persons, particularly politicians who
consider the success of their respective parties of more
consequence than the comfort and happiness of a constitu¬
ency bereft of reason and the right to vote, will feel that it
would be a waste of time to lay bare a distressing, perhaps
disgusting, account of brutalities covering a period that
has passed. If my insight into a situation of this kind is
worth anything, the public will do well to weigh my words
before listening to the biased opinions of those who fear

A MIND THAT FOUND ITSELF

235

the truth. An investigation covering a short period would
be an injustice either to the inmates of an institution or to
its management, or, indeed, to both. A guilty manage¬
ment, anticipating an investigation, could and would tem¬
porarily correct all discoverable abuses. This very thing
has often happened, and always will happen so long as the
instinct of self-preservation persists. Doctors who volun¬
tarily have never lifted a finger to protect their patients
against abuse sit up nights to correct abuses the moment
an investigation becomes imminent — thus proving how
easily their vigilance could be permanently maintained.

I shall cite a case in point. I have already made brief
mention of a stroke of reform brought about in Kentucky
through the efforts of an ex-attendant. It was during the
month of September, 1906, that I happened to be traveling
in that State. As already mentioned I chanced to pick up
a copy of the Louisville Courier-Journal, in which I saw a
heading that caught my eye and soon gripped my heart.
It read as follows: “SAYS PATIENT WAS KILLED —
Charge Publicly Made By Ex-Attendant.” This “ex¬
attendant,” whom I now number among my friends, was
over six feet in height and proportionately powerful.
Because of his great strength he was assigned, upon enter¬
ing the hospital, to a so-called “back ward.” He demurred
at his assignment, preferring to work in a ward where the
patients were comparatively happy. But the doctors made
their orders peremptory — much to their later regret. For,
in the course of his work, this full-blooded man saw sights
which so outraged his manhood that he protested vehe¬
mently to the authorities. His protest went unheeded so
long as he remained in the employ of the State. At last,
when a helpless patient had been killed by brutal atten¬
dants, he resigned and forced the management to take

236

A MIND THAT FOUND ITSELF

heed by bringing the matter before the Governor of Ken¬
tucky, who ordered an investigation. Then, of course,
abuses which might incriminate were virtually corrected
in a night. Brutality ceased. Attendants who, on many
occasions, had bathed in a single tubful of water as many
as fifty men, some of whom had pestilential sores on their
bodies, immediately adopted a more sanitary method; and
whereas, under the old method, the inmates of an entire
ward had been run through a mass of cumulative filth
within two or three hours, under the enforced sanitary
reform it took a like corps of attendants — if not the same
men — the better part of two days to complete their task.1
Does not this wonderful change in methods (if not change
of heart) prove how efficacious an aroused and outraged
public opinion can really be? I say, then, it behooves the
public to assume part of the burden of the afflicted and
oppressed insane by compelling the several managements
to work as well every day in the year as they do when an
investigation impends or is in progress.

One might attempt to justify the retention of an at¬
tendant of known brutality by saying cavalierly that one
vicious attendant is as good as another. This is quite
true, but it does not excuse the employment of any vicious
attendants. Nor can a valid excuse for so doing be devised.
Acceptable if not model attendants can be found if deter¬
mined efforts are made. Weakly taking for granted that

1 These statements regarding improper methods of bathing — an almost
universal abuse in hospitals for the insane — arc based on an affidavit given
me by the “ex-attendant” who instigated the Kentucky investigation.
Though the aforementioned abuse is widespread, its remedy is within easy
reach. Let hospital managements abolish stationary tubs entirely and
install in their stead modern shower baths and the like. However, any law
or rule governing this matter should not be so strict as to prevent the use of
a tub in bathing infirm patients or in the giving of the so-called “continuous
bath” to excited patients.

A MIND THAT FOUND ITSELF

237

the riff-raff which drifts from one hospital to another must
be accepted, some doctors seldom think of actively searching
for good material. Yet, in my opinion, this is one of their
prime duties. No other detail of management is more im¬
portant. The difficulty is not insurmountable. There are
not a few superintendents who have little trouble in secur¬
ing an adequate number of fairly competent attendants,
but these are usually the heads of institutions conducted
on Non-Restraint principles. This fact is not surprising.
The better element among those who seek employment as
attendants, naturally look for it where the patients are
treated with the most consideration; for there the lot of
the attendants is not only bearable, but, oftentimes, a
happy one.

Brutal attendants are arrant cowards. They would fear
to lose their positions more than do most classes of work¬
ers, if they were made to realize that the slightest infraction
of the rules will insure immediate dismissal. The trouble
to-day is that superintendents, generally, do not enforce
rules to the point of dismissal. Thus do those in authority
lose a sure opportunity to frighten brutal men into at least
a semblance of merciful behavior. Why employ brutal men
at all? the reader may wonder. As well ask: why employ
dishonest men as clerks and officers in banks. Evil forces
must ever be reckoned with; therefore it is incumbent on
those in authority to adopt a proper system of espionage,
the enforcement of which will reduce evils to a minimum.
There is scarcely a department of the Federal Government
where just such a system is not now in operation. In busi¬
ness too — especially its more highly developed branches

“supervision” is a watchword. Surely, if the sane find
it necessary to watch those whose work is carried on under
the eyes of the sane, and in the sane world, is it not more

238

A MIND THAT FOUND ITSELF

necessary to watch those thousands whose work is done be¬
hind the locked doors of institutions? The first step in the
enforcement of such a system would be a thorough under¬
standing between the superintendent and attendants at the
time the latter enter upon their duties. Instead of turning
a new attendant over to the old attendants for training, as
is so often done, those in authority should themselves assume
the task of instruction. To be sure, a majority of our
superintendents to-day give words of advice to the newly
hired, but seldom do these preliminary admonitions carry
weight. Those in authority should impress upon the mind
of the novice the fact that his is a responsible position, and
that he must discharge his duties humanely, or submit to
summary dismissal; and especially should male attendants
be so instructed, for few men are willing to take the course
of training which some of our hospitals now offer.

If, also, attendants were made to realize that a dishon¬
orable discharge from one institution would forever bar
them from all others, they would soon learn their lesson. A
man about to be entrusted with the valuables of others is
seldom employed by a commercial institution without a
satisfactory certificate of character. Can we tolerate less
care in the employing of men and women to whom such a
valuable as a human life is to be entrusted? Yet in a
majority of our institutions to-day little care is exercised
in the selection of help. Indeed, hospitals for the insane
seldom have a full complement of attendants, and a ran¬
dom applicant stands an excellent chance of employment.
Hundreds of these “unknowns” are now lording it over
the patients.

As a preliminary measure — and added protection I
advocate a universal statute making it at least a misde¬
meanor for any man or woman, dishonorably discharged

A MIND THAT FOUND ITSELF

239

from one such institution, to accept a position in another;
and likewise a misdemeanor for any doctor in authority in
a state or private hospital to employ as an attendant any
man or woman whose references do not indicate a good
record and some fitness for the work. A sworn statement
on these points from each attendant, when engaged (to¬
gether with his thumb-print, as a means of identification),
would protect the doctors, and this statement, if untrue,
would serve as a basis for criminal prosecution. The moral
effect of such a statute would be such as to render its en¬
forcement seldom necessary. Brutal and dishonest attend¬
ants would thus be forced into other lines of work, in
which they might perhaps become useful members of
society, or, at least, no longer a menace to society’s defence¬
less portion.

We must admit that the problem of securing efficiency
among attendants is not an easy one. To make it easier
several improvements must be made in the lot of the
attendants themselves. For one thing, the niggardly sala¬
ries now offered make it extremely difficult for a manage¬
ment to secure or keep workers of the right type. Com¬
petent men and women can earn two or three times as much
in other and more congenial lines of endeavor. The average
scale of wages for attendants in hospitals for the insane
ranges from sixteen to twenty-four dollars a month, with
room and board. Women usually receive sixteen or eighteen
dollars at the beginning; men from eighteen to twenty,
though the rates vary throughout the country. There is a
slight margin, too, for an increase in salary, but even the
exceptionally able attendants seldom receive more than
thirty dollars a month. This bespeaks a false, a vicious
economy. Not that the average attendant deserves a
cent more than he receives; but would it not be wiser, more

240

A MIND THAT FOUND ITSELF

humane, and, in the end, cheaper, to offer inducements
calculated to attract to this neglected field of service a
higher type of character? — nay, and keep him there, for
nothing is more demoralizing than the constant changing
that goes on in the ranks of the present attendants. To
offer a wage of, say, forty, with a maximum of fifty dollars
a month, including board and room, would, no doubt, be
a move in the right direction.

However, such a merely pecuniary inducement would
not, of itself, accomplish the purpose. Indeed, alone, it
might defeat the purpose. For, after discussing this prob¬
lem with doctors who have employed attendants, I am
brought to the conclusion that increased wages, unaccom¬
panied by increased and deserved privileges, and more
wholesome and refined surroundings, would probably
appeal only to burly workers in rougher fields. Wages
high enough to attract a more refined type are, at the pres¬
ent stage of hospital development, out of the question;
whereas privileges and refining influences might even now
be brought to bear with excellent effect. Model dormito¬
ries, and separate cottages for married employees, instead
of mere sleeping places, shorter and less exhausting hours,
and proper places in which the extra leisure could be en¬
joyed — a library, billiard room, etc., — these would go
farther than money toward the great task of refinement.
It is unfair to keep an attendant on duty twelve or fifteen
hours a day (these are now the common working hours)
and for the balance of his time confine him to his ward
under restrictions nearly as irksome as those to which the
patients themselves must perforce submit. A few States,
notably New York and Massachusetts, have granted ap¬
propriations for the creation of such conditions as I am
describing. If these appropriations were enlarged, and if

A MIND THAT FOUND ITSELF

241

other States followed the same policy, it is safe to predict
that thousands of refined men and women would enter
this field who are now debarred. And once in the work
they should be offered the same chances for advancement
as are offered to employees in any well-conducted commer¬
cial establishment. Such a policy, carried to its logical
conclusion, would include also a system of pensions for com¬
petent attendants who devote the better part of their lives
to this noble service.

Still another effective means of eliminating brutality by
the introduction of refining influences would consist in the
wader employment of women nurses in men’s wards. To
the uninitiated this suggestion will no doubt seem ill-advised;
yet, at this moment, there are in this country — and abroad,
as well, some hospitals for the insane where women
nurses, assisted, of course, by orderlies, as are nurses in
general hospitals, are managing men’s wards with gratify¬
ing success.1 What is needed is a general adoption of this
humane practice. Not all classes of male patients can
safely or advantageously be placed in charge of women
nurses; but other classes — the more intelligent and less
disturbed — comprising thousands, can, if anything, be
managed better by women of capacity than by men of any
sort. The superior tact and quicker sympathy of woman
— God-given qualities — work wonders in hospitals for
the insane quite as readily as in the sane world. It cannot
be denied that under the present regime women nurses in
charge of troublesome women patients have not been
entirely free from charges of cruelty; indeed, the contrary
has been proved, as the results of investigations show —
but they are far less subject to this charge than men

1 Sec article on this subject by Dr. Charles P. Bancroft
Journal °f Insanity, Vol. LXIII, No. 2, October, 1906.

, in American

17

242

A MIND THAT FOUND ITSELF

attendants. According to those superintendents who have
successfully placed women nurses in charge of men’s wards,
thousands of male patients who now suffer at the hands of
unfeeling and incompetent male attendants could be
brought under remedial and uplifting influences simply by
having women placed over them in positions of authority.
And the salutary influence of women in wards where they
are available would have a tendency, as experience has
demonstrated, to spread throughout all other wards where
their immediate presence is impracticable or unsafe. It
would therefore seem desirable to substitute female for male
nurses wherever possible.

Such a course, too, would further simplify the problem of
securing an adequate number of attendants. The services
of women are easier to secure, and women readily take up
nursing as a profession — as a life-work; whereas men
naturally look upon such work simply as a means of pro¬
viding a livelihood until they can secure work more to their
liking.

There are in this country over twenty thousand men
and women working as attendants in our asylums and
hospitals for the insane. Of this number several thousand
are, without doubt, individuals of refinement. Now, if a
few thousand persons of refinement can work under such
conditions as obtain so generally to-day in our hospitals
and asylums, is it not reasonable to suppose that improved
conditions would eventually attract a full complement of
workers of the same type? Strange as it may seem, many
attendants now so employed enjoy their work and would
not of their own choice relinquish it. And I make bold
to appeal to those thousands now eking out a liveli¬
hood in work apparently more attractive, but, in truth,
less endurable, to seek improved conditions and increased

A MIND THAT FOUND ITSELF

243

usefulness in those hospitals where the application of the
Golden Rule to the insane is now possible. In such
places a feeling of security and interest soon overcomes
the instinctive timidity or repugnance felt by many when,
in the capacity of attendants, they first come in contact
with the insane. Such contact, barring exceptional cases in¬
fluenced by a too impressionable temperament on the part
of the nurse, renders one, as it were, immune. It would
surprise (perhaps annoy) many sane persons, were they
to realize how slightly many of the patients differ from
their more fortunate brothers at large. Yet among those
who have been brought into close contact with the insane
this is a trite observation; and it is the key to the problem
which causes so many to wonder how and why it is that
men and women, at liberty to choose their vocations, delib¬
erately cast their lot with that portion of humanity which
the average person seems so willing to shun.

Continued study of the subject since 1907, when the
preceding part of this chapter was originally written, has
caused me to modify my views regarding the kind of
investigation most likely to be effective. While public
investigations and their accompanying newspaper exploita¬
tion of abuses” may still be necessary in some States _ •

where standards of care are unwarrantably low, or where
hospitals for the insane are still under pernicious political
control a more effective method has been found. This
method of investigation, known as a “survey,” consists of
a careful study of conditions made by a psychiatrist
selected by The National Committee for Mental Hygiene
and working under its direction. Such surveys have
already been completed or are under way in California,
Colorado, Connecticut, Georgia, Louisiana, Pennsylvania’
South Carolina, Tennessee, Texas, and Wisconsin, — also in

244

A MIND THAT FOUND ITSELF

two cities, New York and Chicago. These surveys are
made, under a grant from the Rockefeller Foundation,
without expense to those desiring them. All that is required
is that an invitation be extended to the National Committee
by the proper authorities. That such invitations are being
sent to it by Governors, State Boards and Commissions
and by State Hospital officials, also by county and local
officials, is proof in itself that this survey method is destined
to render obsolete the so-called legislative investigation and
“investigation” by sensational newspapers.

Though more will be said about surveys in Part V, a
summary of one, by way of illustration, is now presented.
In an article which appeared on April 3, 1915, in “The
Survey,” written by my associate, Dr. Thomas W. Salmon,
Medical Director of the National Committee for Mental
Hygiene, the survey made in South Carolina at the invita¬
tion of Governor Richard I. Manning is described. Among
other things, it shows that, while a “legislative investi¬
gation” failed to produce any results, the survey succeeded
in producing lasting results in a remarkably short time.
To quote:

Although many states, under the influence of waves of popular
interest, have done for their insane in a year what it would have
taken ten years to accomplish at the usual rate of progress, it
has remained for South Carolina, during a single session of the
General Assembly lasting only forty days, to take steps which
will transform the care of the insane from the standards of
i860 to those of the present time.

Intermediate steps which have been taken painfully, one at
a time, in other states during the last fifty years, are to be
omitted altogether in the work which South Carolina has
authorized, and the transition will be made so quickly and so
completely that patients who entered an obsolete asylum a few
months ago may, within the same walls, receive tieatment in a

A MIND THAT FOUND ITSELF 245

modern state hospital for the insane before the end of the
present year.

As a result of several causes which are not important in this
connection and which are not in any way peculiar to South
Carolina, progress in that state did not include the public
institution in which the insane are cared for. Although the care
of the insane in the state remained stationary, the citizens of
South Carolina, however, shared fully in the general enlighten¬
ment which has advanced the care of the sick and, in 1909, the
General Assembly was induced to pass an act providing for
a committee to investigate the past and present affairs of the
state hospital at Columbia and to make such recommendations
for the welfare of the patients as its findings justified. The
report of this committee, which was published in 1910, shows
that its members undertook their task with zeal and intelli¬
gence. . . . The committee summarized its findings by the
statement that the institution was unfit to be used even as a
place of detention. The recommendations of this committee
were published in the newspapers, and in the annual report of
the institution to the General Assembly. The superintendent
urged, as he had done long before the creation of this committee,
that the appalling conditions be remedied; but in the turmoil
of party strife his recommendations were unheeded. One of
the last acts of Governor Blease was to remove him from office.
Thus, as far as any practical results of this committee’s report
were concerned, the matter rested just about where the com¬
mittee had left it until Governor Richard I. Manning took office
on January 19, i9I5.

Even before Governor Manning was inaugurated, he planned
t e most effective means for dealing with a situation which
deeply involved the honor of his state. He realized that an
accurate diagnosis must precede treatment, and that both
lagnosis and treatment were the work of an expert. Through
the National Committee for Mental Hygiene, which had been
following the situation in the hope of being of service, it was
possible to secure the services of Dr. Arthur P. Herring, Secre-

246 A MIND THAT FOUND ITSELF

tary of the Maryland State Lunacy Commission, to make a
careful study of the situation. Dr. Herring not only possessed
a sound knowledge of psychiatry and of the administration of
institutions for the insane, but, in taking the insane of Mary¬
land out of the county asylums and almshouses and providing
for them in state hospitals, he had acquired just the kind of
experience and resourcefulness demanded for the task of finding
a practical way out in South Carolina.

On the day that Governor Manning took office, Dr. Herring
commenced work and within a month his report had been
transmitted to the General Assembly by the Governor in a
special message. This report differed from that of the legisla¬
tive committee of 1909 in that it set forth the conclusions 01 a
trained observer who, being familiar with all phases of the care
of the insane, could compare the conditions observed directly
with those which he knew were required. His report was termed
a ‘dispassionate review’ by the “ Columbia State, and it carried
such conviction with it that, under the leadership of Governor
Manning, the General Assembly adopted its broad constructs e
recommendations for administrative reform and, without a dis¬
senting vote, appropriated the $600,000 required to reconstruct
the buildings of the institution in accordance with the plans
presented.

Governor and legislature can do in any state what Governor
Manning and the members of the General Assembly have done
in South Carolina.

Not the least important result of surveys of conditions
among the insane is the knowledge gained regarding
the care and treatment of the insane outside of hos¬
pitals. Their care in county poor farms, almshouses,
jails, prisons and other unsuitable places, and the mis¬
management of cases in the community has been found,
in some instances, to be little less than a disgrace.
More will be said in Part V about this phase of the

work.

XXX

But the problem of attendants is not the only pressing
one. Any alienist will agree, that the cure of the insane
depends upon their care , and that to this end a proper
classification is necessary. This can be accomplished only
when the curable cases can be given individual attention.
The manifestations of insanity vary with the original tem¬
peraments of those afflicted. Collective treatment is now
the rule; but not until individual treatment prevails will
the ratio of recoveries begin to move toward that inspiring
figure which due progress in the care of the insane must even¬
tually show. For the moment each patient receives the care
which is his rightful portion, all abuses complained of will
be doomed. Such care will kill cruelty at its source.

In the general hospital there are wards set apart for the
treatment of certain diseases. Does any one believe that
twenty patients, ill with typhoid fever, should, for an indefi¬
nite period, be given the same kind of medicine and the same
kind of food at the same hour each day? Such treatment
would result in the death of many who, with individual
treatment, would recover. Yet, in a single ward in a hos¬
pital for the insane, twenty, thirty, forty, sometimes sixty,
sometimes more than sixty patients, each in a different state
of physical and mental health, arc forced to submit to a uni¬
form mode of living which, in a majority of cases, is not
at all conducive to their well-being. In many instances
this machine-like existence has been the death of patients
who might have been restored to health had they been given
exercise and diversion, and food of a quality and variety

247

248

A MIND THAT FOUND ITSELF

calculated to tempt their jaded appetites.1 It is trite to ob¬
serve that mental health depends largely upon bodily health.
Since this is so, hospital managements might think less of
administering drugs, and what amounts to punishment, and
more about providing a suitable diet, exercise, and proper
application of what mind remains, for those whose condition
so clearly demands these requisites of intelligent treatment.
The total cost would be less. Instead of feeding and caring
for, year in and year out, the once curable cases become
chronic, the State might better spend more money for a
shorter period, restore the sick to health, and convert a
burden into a joy.

There are doctors in our State Hospitals who will tell you
that to treat certain cases on their merits will demoralize
those patients whose condition is such that individual treat¬
ment seems unnecessary or hopeless. As most asylums are
now conducted, the individual treatment of the few might
arouse a feeling of discontent among those denied special
privileges. But would any such demoralization ensue if each
patient was treated with that consideration he so richly
deserves ? I know that it would not. When one patient sees
a fellow-patient allowed more liberty, or perhaps granted a
more inviting diet than himself, it is not so much a feeling of
jealousy or envy that seizes him — in his heart he is glad that
some one of his kind is given pleasure. What he rebels
against is the fact that he himself is denied, not special priv¬
ileges, but those ordinary benefits which in any hospital
deserving of the name would be his without the asking.

1 As chances of recovery never cease to exist, and as statistics show that
twenty out of each hundred who recover, do so after one or more years of
confinement, the standard of care for even the so-called chronic cases can
never be lowered without robbing some patients of their rightful chance of
rescue. Apparently hopeless cases which recover after ten, fifteen, or twenty
years of absolute insanity are by no means rare, as can be proved by a
study of hospital records.

A MIND THAT FOUND ITSELF

249

Another objection which the management of a state hos¬
pital sometimes makes to the plea for individual treatment
is that under the law one patient is as deserving as another,
and that the granting of privileges, favors, etc., to the com¬
paratively few curable cases cannot be accomplished with¬
out working an injustice to the many whose condition does
not demand exceptional care. The glib way in which those
in authority in a state hospital prate about justice would
bring a smile to the face of the shy goddess who perhaps pre¬
sides over that virtue. These expounders of Equal Rights
for All will refuse to alter a general and mechanical course
of treatment which is admittedly crude and unproductive of
good results; yet these very men seem willing to discriminate
between patients so long as the discrimination leads not to
exceptional privileges but to exceptional privations.

Though those in authority are deserving of considerable
criticism there are many reasons why they should be treated
with all charity. If we are to demand that doctors treat each
patient as though he were the only one in the world, we
must, through the several State Legislatures, provide funds
for the proper equipment and manning of our institutions.
To-day there are few institutions where the doctors in charge
have not under their care a greater number of patients than
can be properly treated. Nor are there many institutions
regularly provided with an adequate corps of attendants.
Indeed, if the United States Government were to send into
an engagement a battleship as poorly manned as are our
asylums, the people would rise in their indignation and de¬
mand that the honor of the Nation be given into other keep¬
ing. To my, perhaps prejudiced, mind, the honor of this
Nation is open to attack so long as the States force, or
permit, great institutions to proceed in their work with de¬
fective equipment or an inadequate complement of workers.

XXXI

But more fundamental than espionage, and more funda¬
mental than individual as opposed to collective treatment,
is the need of a changed spiritual attitude toward the insane.
They are still human: they love and hate, and have a sense
of humor. The worst are usually responsive to kindness.
In not a few cases their gratitude is livelier than that of nor¬
mal men and women. Any person who has worked among
the insane, and done his duty by them, can testify to cases
in point, and even casual observers have noted the fact that
the insane are oftentimes appreciative. Consider the ex¬
perience of Thackeray, as related by himself in “Vanity
Fair” (Chapter LVII). “I recollect,” he writes, “seeing,
years ago, at the prison for idiots and madmen, at Bicetre,
near Paris, a poor wretch bent down under the bondage of
his imprisonment and his personal infirmity, to whom one
of our party gave a halfpennyworth of snuff in a cornet or
‘screw’ of paper. The kindness was too much for the poor
epileptic creature. He cried in an anguish of delight and
gratitude; if anybody gave you and me a thousand a year,
or saved our lives, we could not be so affected.”

A striking exhibition of fine feeling on the part of an in¬
mate of an asylum was brought to my attention by an assist¬
ant physician whom I met while inspecting a certain State
Hospital in Massachusetts. It seems that the patient in
question — a woman — while at her worst had caused an
endless amount of annoyance by indulging in mischievous

250

A MIND THAT FOUND ITSELF

25*

acts which seemed to verge on the malicious. Judged by
her conduct at that time no observer would have credited
her with the exquisite sensibility she so signally displayed
when she had become convalescent and was granted a
parole which permitted her to walk at will about the
hospital grounds. After one of these walks, taken in
the early spring, she rushed up to my informant and, with
childlike simplicity, told him of the thrill of delight she
had experienced in discovering the first flower of the year
in full bloom a dandelion, which, with characteristic
audacity, had risked its life by braving the elements of an
uncertain season.

“Did you pick it?” asked the doctor.

“I stooped to do so,” said the patient; “then I thought
of the pleasure the sight of it had given me — so I left it,
hoping that some one else would discover it and enjoy its
beauty as I did.”

Thus it was that a woman, while still insane, unconsciously
exhibited perhaps finer feeling than did Ruskin, Tennyson,
and Patmore, on an occasion the occurrence of which is
vouched for by Mr. Julian Hawthorne. These three masters,
out for a walk one chilly afternoon in late autumn, discovered
a belated violet bravely putting forth from the shelter of a
mossy stone. Not until these worthies had got down on all
fours and done ceremonious homage to the flower, did they
resume their walk. Suddenly Ruskin halted, and, planting
his cane in the ground, exclaimed, “ I don’t believe, Alfred^
— Coventry, I don’t believe that there are in all England
three men besides ourselves who, after finding a violet at
this time of year, would have had forbearance and fine feel¬
ing enough to refrain from plucking it.”

The reader may judge whether the unconscious display
of feeling by the inmate of an asylum was not finer than

A MIND THAT FOUND ITSELF

252

the self-conscious raptures of these three wise men and
sane.

Is it not then an atrocious anomaly that the treatment
often meted out to an insane person is the very treatment
which would deprive a sane person of his normal capacity ?
The victim must right his reason in an atmosphere of un¬
reason. He must check his own delusions with the delu¬
sions of others as mad as himself; and he must submit to a
variety of abuses as cruel as they arc unnecessary. That
so many insane persons recover their reason under ad¬
verse conditions is pretty good proof that insanity, though
prevalent, can never become preponderant. Miners who
penetrate the mountain fastnesses frequently become men¬
tally unbalanced as a result of prolonged loneliness, and
their knowledge that they imperil their reason by li\ing
in solitude, and their willingness to take the risk, are
qualifications for the work. But one and all they hasten
to return to civilization the moment they find themselves
beginning to be slightly affected with hallucinations. Delay
means death. Contact with sane people, if not too long
delayed, means an almost immediate restoration to nor¬
mality. This is an illuminating fact. For, if contact
with the sane world can restore the threatened reason of
these miners, why cannot the minds of the inmates of
our asylums be at least strengthened by contact with
sound minds? Inasmuch as insane patients cannot be
set free, it is the duty of those in authority to treat them
with as great a degree of sane consideration as possible.
Instead of discouraging and abusing those curable patients
who exhibit flashes of sanity, why not, on the contrary,
single them out and encourage them in the direction of right

A MIND THAT FOUND ITSELF

253

thinking ? In my own case I know that my degree of sanity
varied with the sanity of the treatment accorded me. I can
recall one wholesome interview which I had with my con¬
servator and a friend. It eliminated more insane notions
from my mind than all the hours of talk I had previously
had with doctors and attendants. These two men — my con¬
servator and my friend — in a spirit of tolerance and friend¬
liness pointed out the impracticability of some of my wild
schemes, and their arguments were so convincing that I soon
accepted them and saw the absurdity of my own delusions.
Such arguments would of course be without effect at certain
stages, but, during a period which seems to point toward nor¬
mality, friendly advice will without question hasten recovery.

Not a few of the inmates of our asylums, if they enjoyed
this individual and humane treatment, directed primarily
toward their own interests, might to-day be set free. And
many others not quite fit for absolute freedom might well be
set free on parole. I firmly believe that the public should be
protected against the insane, and the insane against them¬
selves; but I see no reason why society, which so little heeds
its most unfortunate portion, is deserving of an excessive de¬
gree of protection at the expense of recovered patients who
have already endured unnecessary suffering because of the
public’s neglect. Society would not be likely to suffer any
more than it suffers already because of the continued free¬
dom of hundreds of so-called “queer” people who would
have a poor chance of ever regaining their freedom were
they once legally deprived of it. I do not mean to say that
any considerable number of the present inmates of our asy¬
lums and hospitals have been illegally committed, or that they
are wittingly held longer than seems necessary. But innocent
men have been condemned and hanged, and it stands to
reason that an undeterminable number of persons out of the

254

A MIND THAT FOUND ITSELF

two hundred thousand mental incompetents in this country,
have been unjustly and, in some cases, maliciously branded as
insane when they did not deserve that infliction. So long
as the human equation enters into the problem, such errors
— or crimes — cannot possibly be completely guarded against.

That the unwarranted commitment of a person to a hos¬
pital for the insane is a tragic miscarriage of justice, all will
admit. It therefore follows that the holding of a patient for
an unwarranted length of time after commitment is also an
injustice — likewise tragic. Yet many patients are deprived
of their liberty longer than necessary. This fact, however,
is seldom the fault of the doctors in charge of them, except,
perhaps, in private, run-for-gain institutions. As a rule
public hospital officials are more than willing to discharge
any patient fit for freedom — if for no other reason, to re¬
lieve the overcrowded condition which obtains in a majority
of public institutions. It is the indifference — or even hos¬
tility — of a patient’s relatives which most often forces an
asylum management to hold him for weeks or months —
sometimes years — after he has demonstrated his fitness for,
at least, a large degree of freedom. Rather than force a
patient out into a world which, at best, is cold, the doctors
will detain him until he is truly able to shift for himself. Rel¬
atives, who are contributing to their own selfish comfort by
leaving the care of their unfortunates to the State, should
pause and try to view life from behind asylum bars.

So much for those luckless patients whose relatives or
friends fail to do their whole duty by them. But what of
those inmates — and there are hundreds of them discharged
each year in this country — what of those who have no rel¬
atives or friends at all, either to help or to hinder them when
their liberation is about to occur? In behalf of this class I
wish to call attention to a work, only recently inaugurated in

A MIND THAT FOUND ITSELF 255

this country, though long since practiced abroad, which is
deserving of support and of general adoption. I refer to
the “After Care of the Insane.” Thanks to the initiative
of Miss Louisa Lee Schuyler of New York, the State Char¬
ities Aid Association of that city has brought to a working
perfection several so-called “After Care Committees.” These
are composed of earnest men and women who lend assist¬
ance to needy and friendless patients about to re-enter the
sane world. Four hospitals in New York State are now
provided with the co-operation of such committees, and be¬
fore a great while presumably every hospital for the insane
in that State will be likewise provided. No institution of
the character discussed should be without this provision, for
it is just such outside assistance that is required, if all pa¬
tients deserving of discharge are to secure their freedom the
moment they are ready for it.

Realizing that my detailed account of abuses may disturb
relatives and friends of the inmates of our hospitals for the
insane, I feel it my duty to express again my belief that most
insane persons are better off in an institution than out of one.
Only a comparatively small, though undeterminable, pro¬
portion of the two hundred thousand inmates of our hospitals,
asylums and sanatoriums are subjected to the worst of the
abuses laid bare and discussed in this book. This is at least
reassuring; for investigation and reform must soon remedy the
evils complained of; and country-wide investigation, if it does
nothing else, will protect insane patients against abuse as they
never before have been protected. Then, before the wave
of reform shall have lost its force, a National Society can take
hold and help, or, if necessary, force all hospital manage¬
ments to maintain the highest attainable standard. Abuse
and injustice will then become as myths; — and, at last,
the insane will come into their own.

PART III

XXXII

Such convictions as the foregoing — or some of them, and
the germs of the rest — I carried with me into the world.

For the first month of regained freedom I remained at
home. These weeks were interesting. Scarcely a day
passed that I did not meet several former friends and
acquaintances who greeted me as one risen from the dead.
And well they might, for my three-year trip among the
worlds — rather than around the world — was suggestive
of complete separation from the every-day life of the multi¬
tude. One profound impression which I received at this
time was of the uniform delicacy of feeling exhibited by my
well-wishers. In no instance that I can recall was a direct
reference made to the nature of my recent illness, until I had
first made some remark which indicated that I was not
averse to discussing it. There was an evident effort on the
part of friends and acquaintances to avoid a subject which
they naturally supposed I wished to forget. Knowing that
their studied avoidance of a delicate subject was inspired by
a thoughtful consideration, rather than a lack of interest, I
invariably forced the conversation along a line calculated to
satisfy a suppressed but perfectly proper curiosity which I
seldom failed to detect. My decision to stand on my past
and look the future in the face has, I believe, contributed
much to my own happiness, and, more than anything else,
enabled my friends to view my past as I myself do. By
frankly referring to my experiences I put my friends and

256

A MIND THAT FOUND ITSELF

257

acquaintances at ease, and at a stroke rid them of that
constraint which one must feel in the presence of a person
constantly in danger of being hurt by a chance reference to
an unhappy experience.

I have said much about the obligation of the sane in refer¬
ence to easing the burdens of those committed to our asylums.
I might say almost as much about the attitude of the public
toward those who survive such a period of exile, restored,
but branded with a suspicion which only time can efface.
Though an ex-inmate of an asylum receives personal con¬
sideration, he finds it unduly difficult to obtain employment.
No fair-minded man can find fault with this condition of
affairs, for an inbred horror of insanity breeds distrust of one
who has been insane. Nevertheless, this attitude is a mis¬
taken one. Perhaps one reason for this lack of confidence
in an ex-inmate is to be found in the lack of confidence which
such a person often feels in himself. Confidence begets
confidence, and those men and women who survive mental
illness should attack their problem as though their absence
had been occasioned by any one of the many circumstances
which may interrupt the career of a person whose mind has
never been other than sound. I can testify to the efficacy
of this course, for it is the one I pursued. And I think that
I have thus far met with as great a degree of success as I
might reasonably have expected to attain had my career
never been all but fatally interrupted.

Discharged from the asylum in September, 1903, late in
October of that same year I went to New York. Primarily
my purpose was to study art. I even went so far as to
gather information regarding the several schools; and, had
not my artistic ambition taken wing, I might have worked
for recognition in a field where so many strive in vain. But
my business instinct, revivified by the commercially sur-

258

A MIND THAT FOUND ITSELF

charged atmosphere of New York, soon gained sway, and,
within three months I had secured a position with the same
firm for which I had worked when I first went to New York
— six years earlier. It was by the merest chance that
I made this most fortunate connection, which has continued
ever since. By no stretch of my rather elastic imagination
can I even now picture a situation that would, at one and
the same time, have so perfectly afforded a means of liveli¬
hood, leisure in which to indulge my longing to write, and
an opportunity to further my humanitarian projects.

Though persons discharged from our asylums are usually
able to secure, without much difficulty, work as unskilled
laborers, or positions where the responsibility is slight, it is
often next to impossible for them to secure positions of trust.
That I did secure such a position naturally arouses within me
a lively sense of gratitude toward the members of that firm
which helped me to lift myself over as rough a spot on life’s
road as one may expect to fall upon. And what pleases me
to-day, and pleased me then, is that the two men who com¬
prise the firm in question did not employ me solely because
of a desire to help me when I so much needed help. Knowing
my past, they yet engaged my services because they thought
they saw in me certain qualifications for the proposed work.
During the negotiations which led to the engagement I was
in no suppliant mood. If anything, I was quite the reverse;
and, as I have since learned, I imposed terms with an assur¬
ance so sublime that any less degree of audacity would have
put an end to the negotiations then and there. But the man
with whom I was dealing was not only broad-minded, he
was sagacious. He recognized immediately such an ability
to take care of myself as argued an ability to protect the in¬
terests of the firm in the particular line of work he had in
mind. But this alone would not have induced the average

A MIND THAT FOUND ITSELF

259

business man to employ me under the circumstances. It
was the common-sense view of insanity on the part of my em¬
ployer which determined the issue. This view which is,
indeed, exceptional to-day, will one day (within a few genera¬
tions, I believe) be too commonplace to deserve special men¬
tion. As this man tersely expressed it: “When an employee
is ill, he’s ill, and it makes no difference to me whether he
goes to a general hospital or an asylum. Should you ever
find yourself in need of treatment or rest I want you to feel
that you can take it when and where you please, and work for
us when you are able.” When a majority of men attain to
this advanced view, insanity will take its proper place with
other ills which flesh is heir to. Of course, I do not deny
that one employing an ex-inmate of an asylum must care¬
fully judge his capacity and assign him to work for which
he is fitted.

Strangely enough, that “missionary spirit” (if you will)
which now impels me to try to spread the principles of Non-
Restraint has been nurtured and strengthened by the daily
discharge of those business obligations which (if I may be
pardoned) I shall now briefly describe. What my employers
asked me to do was to introduce over a large territory a cer¬
tain business principle, which, if universally adopted, would
revolutionize a great industry. For three years I have gone
from State to State — from Maine to New Mexico _ pre¬

senting and explaining a special form of contract under
which, for an agreed amount and without “extras,” certain
types of buildings may be erected, from plans to completion,
and delivered to the purchaser, ready for occupancy. The
purchaser, or owner, deals directly with but one firm, which
acts as owner pro tem , and guarantees a satisfactory result.
Those who have erected buildings under the usual method,
namely, that of placing the entire operation in the hands of

260

A MIND THAT FOUND ITSELF

an architect, who in turn, in the name of the owner, lets
out the work to several contractors for competitive bidding,
will at once grasp the significance of this revolutionizing
method.

The presentation of so unique a contract requires a degree
of persuasiveness and audacity. Though I have not met
with an unusual degree of success, I have secured a sufficient
number of contracts to warrant my being kept on the list
of employees of the firm which had the courage to send me
abroad in the land as its representative. My business mis¬
sionary work has been done among bankers in three hundred
cities and towns. Contact with two or three thousand such
men in the North, East, South, and Southwest has, in every
way, been beneficial to me. Not only have I talked with
them. I have talked “at” them, endeavoring to convert them
from an old and unsatisfactory method to a new and prac¬
tical one. Many a time have I smiled inwardly when I
found myself thus addressing a Board of Directors, or
Building Committee, about to let a contract for a new
building or the remodeling of an old banking room.
For, at such times my memory invariably presents two
pictures of similar (but how different!) scenes — one, that
of my appearance before a clinic of \ale medical stu¬
dents, held at the State Hospital while I was possessed of
a remarkably complete collection of delusions of grandeur
which I willingly, yes, eagerly, laid on the Altar of Science.
The other, that in which I appeared before the Medical Staff
at the same hospital, prior to my discharge. These
two occasions marked my first attempts at speech-making.
My next talk of sufficient length to be called a speech was
delivered before a Board of Directors. After listening to me
they signed a contract for a sixty-thousand-dollar building.
Aside from the preliminary nerve-racking hiatus which mvari-

A MIND THAT FOUND ITSELF

261

ably precedes a speech, I found it easy to monopolize the
attention of my listeners. It would seem, therefore, that the
training I received in an institution not commonly classed as
one of learning proved to be of decided utility.

Dealing almost exclusively with bankers — those hard-
worked men of seemingly easy hours — I have enjoyed al¬
most as much leisure for reading and trying to learn how to
write as I should have enjoyed had I had an assured income
that would have enabled me to devote my entire time to
these pursuits. And so congenial has my work proved, and
so many places of interest have I visited, that I might rather
be classed as a “commercial tourist” than as a commercial
traveler. To view almost all of the natural wonders and
places of historic interest east of the Mississippi - and many
West of Jt; t0 meet and know representative men and
women; to enjoy an almost uninterrupted leisure, and at
the same time, earn a livelihood - these advantages bear me
out m the feeling that in securing the position I did, at the
time I did, I enjoyed one of those rare compensations which
Fate sometimes bestows upon those who survive unusual

XXXIII

When I regained my liberty (September, 1903) I real¬
ized that I could not successfully advocate reforms in hos¬
pital management until I had first proved to relatives and
friends my ability to earn a living. And I knew that, after
securing a position in the business world, I must first satisfy
my employers before I could hope to persuade others to join
me in prosecuting the reforms I had at heart. Consequently
during the first year of my renewed business activity (the
year 1904) I held my humanitarian project in abeyance and
gave all my executive energy to my business duties. During
the first half of that year I gave but little time to reading and
writing, and none at all to drawing. In a tentative way,
however, I did occasionally discuss my project with intimate
friends; but I spoke of its consummation as a thing of the
uncertain future. At that time, though confident of accom¬
plishing my set purpose, I believed I should be fortunate if
my projected book were published before my fortieth year.
That I am able to publish it eight years earlier is due to one
of those unlooked for combination of circumstances which
sometimes causes a hurried change of plans.

The events of November and December 1904, and Jan¬
uary, 1905, must be mentioned, and then I shall have told
the reader about most of my personal fortunes. Late in the
fall of 1904, a slight illness detained me for two weeks,
in a city several hundred miles from home. The illness itself
amounted to little, and, so far as I know, had no direct bear¬
ing on later results, except that in giving me an enforced vaca-

A MIND THAT FOUND ITSELF

tion it afforded me an opportunity to read several of the
world’s great books — books which people are prone to
reserve until a period of leisure reminds them of their for¬
mer neglect.

One of these was “Les Miserables.” It made so deep an
impression on me that I am inclined to believe it started a
tram of thought which gradually grew into a purpose so all-
absorbing that I might have been overwhelmed by it, had
not my over-active imagination been brought to bay by
another’s common sense. Hugo’s plea for suffering Human¬
ity -for the world’s miserable -struck a responsive chord
within me. Not only did it revive my latent desire to help
the afflicted; it did more. It aroused a consuming desire
to emulate Hugo himself, by writing a book which should
arouse sympathy for and interest in that class of unfortu¬
nates in whose behalf I felt it my peculiar right and duty to
speak. I question whether any one ever read “Les Mis£-
erables ” with intenser interest or feeling. I read the entire
work within a few days. By day I read the story until my
head ached; by night I dreamed of it. Then and there I
resolved that I should lose no time in the beginning of mV
own work. 3

To resolve to write a book is one thing; to write it _

fortunately for the public — is quite another. Though I
wrote letters with ease, I soon discovered that I knew
nothing of the vigils or methods of writing a book. Even
then I did not attempt to predict just when I should begin to
commit my story to paper. But, a month later, a member
of the firm made a remark which acted as a sudden spur.

ne day, while discussing the business situation with me he
informed me that my work had convinced him that he had
made no mistake in engaging me when he did. Naturally I
was pleased. I had vindicated sooner than I had hoped his

264

A MIND THAT FOUND ITSELF

judgment in selecting me for a unique work. Aside from
appreciating and remembering his compliment, at the time
I paid no more attention to it. Not until two weeks later
did the force of his remark exert any peculiar influence on
my plans. During those weeks it apparently penetrated
to some subconscious part of me — a part which, on prior
occasions, had assumed such authority as to dominate my
whole being. But, in this instance, the part that became
dominant did not exert an unruly or even unwelcome influ¬
ence. Full of interest in my business affairs one week, the
next I not only had no interest in them, but I had begun even
to dislike them. From a matter-of-fact man of business I
was transformed into a man whose one thought was the
amelioration of suffering among the afflicted insane. Travel¬
ing on this high plane of ideal humanitarianism I could get
none but a distorted and dissatisfying view of the life I must
lead if I should continue to devote my time to the compara¬
tively deadening routine of commercial affairs. Thus it
was inevitable that I should focus my attention on my human¬
itarian project. During the last week of December I sought
ammunition by making a visit to the two institutions where
I had once been confined as an incompetent. I went there
to discuss certain phases of the subject of reform with the
doctors in authority. I was politely received and listened
to with a degree of deference which was, indeed, satisfying.
Though I realized that I was rather intense on the subject
of reform I did not have that clear insight into my state of
mind which the doctors had. Indeed, I believe that only
those expert in the detection of symptoms of a slightly
disturbed mental condition could possibly have observed
anything abnormal about me at that time. Only when I dis¬
cussed my fond project of reform did I betray an abnormal
stress of feeling. I could talk as convincingly about business

A MIND THAT FOUND ITSELF

265

as I had at any time in my life; for, even at the height of
this “wave of enthusiasm,” I dealt at length with a certain
banker who finally placed with my employers a large con¬
tract.

After conferring with the doctors, or rather — as it proved
— exhibiting myself to them, I returned to New Haven and
discussed my project with the president of Yale University.
He listened patiently — he could scarcely do otherwise —
and did me the great favor of interposing his judgment at a
time when I might have made a false move. I told him that
I intended to visit Washington at once, and enlist the aid of
the President; also that of the Secretary of State, Hon. John
Hay, who was then alive. Dr. Hadley tactfully dissuaded me.
He advised me not to approach these two gentlemen until I
had more thoroughly crystallized my ideas and committed
them to paper. His wise suggestion I had the wisdom to
adopt.

The next day I went to New York, and on January 1st, 1905,

I began to write. Within two days I had written about fif¬
teen thousand words — for the most part on the subject of
reforms and how to effect them. By way of mental diver¬
sion I wrote personal letters to intimate friends. One of
these produced a result unlooked for. It was so well writ¬
ten that its recipient jumped at the conclusion that I had
again lost my poise. There were about it compromising ear¬
marks which he recognized. I intimated that I was about to
approach a certain man of wealth and influence in New York,
with a view to securing some action that would lead to reform.
That was enough. My friend showed the letter to my brother
— the one who had acted as my conservator. Upon reading it
he knew at once that I was in an excited mental condition.
But he could not very well judge the degree of the excite¬
ment, for when I had last talked with him — a week earlier

266 A MIND THAT FOUND ITSELF

— I had not discussed my large plans. Business affairs
and my hope for business advancement had then alone
interested me.

I talked with President Hadley on Friday; Saturday I
went to New York; Sunday and Monday I spent at the
Yale Club, writing; Tuesday, this tell-tale letter fell under
the prescient eye of my brother. That day, Tuesday, he at
once got in touch with me by telephone. We briefly dis¬
cussed the situation. He did not intimate that he believed
me to be in elation. He simply urged me not to attempt to
interest any one in my project until I had first returned to
New Haven and discussed it with him. Now I had already
gone so far as to invite the members of the firm to dine with
me that very night at the Yale Club, for the purpose of in¬
forming them of my plans. This I did, believing it to be only
fair that they should know what I intended to do, so that
they might dispense with my services should they feel that
my plans would in any way impair my usefulness as an
employee. Of this dinner engagement, therefore, I told my
brother. But, so insistently did he urge me to defer any
such conference as I proposed until I had talked with him
that, although it was too late to break the dinner engage¬
ment, I agreed to avoid, if possible, all reference to my
project. With that qualified but well-meant promise, and
the promise to return home the next day, our telephone
conference ended.

That night my guests honored me as agreed. For an
hour or two we discussed business conditions and affairs in
general. Then, one of them referred pointedly to my im¬
plied promise to unburden myself on a certain subject, the
nature of which he did not, at the time, know. I immediately
decided that it would be best to “take the bull by the horns,
submit my plans, and, if necessary, sever my connection

A MIND THAT FOUND ITSELF

267

with the firm, should its members force me to choose (as I
put it) between themselves and Humanity. I then pro¬
ceeded to unfold my scheme; and, though I may have ex¬
hibited a decided intensity of feeling during my discourse,
at no time, I believe, did I overstep the bounds of what
appeared to be sane enthusiasm. My employers agreed that
mv purpose was commendable, — that, no doubt I could and
would eventually be able to do much for those I had left be¬
hind in a durance I so well knew to be vile. Their one warn¬
ing was that I seemed in too great a hurry. They called
m> attention to the fact that I had not been long enough
re-established in business to approach successfully and per¬
suade men of wealth and influence to take hold of my pro¬
ject. And one of my guests very aptly observed that I could
not afford to be a philanthropist, which objection I met by
saying that all I intended to do was to supply ideas for those
able to apply them. The conference ended satisfactorily.
My employers disclaimed any personal objection to my pro¬
ceeding with my project if I would, and yet remaining in
their employ. They simply urged me to “go slow.” “Wait
until you re forty,” said one. I then thought that I might
do so. And perhaps I should have waited so long had not
the next two days put me on the right road to an earlier
inauguration of my cherished plans.

The next day, January 4th, true to my word, I went home.
That night I had a long talk with my brother. I did not
suspect that a man like myself, capable of dealing with
bankers and talking for several consecutive hours with his
employers without arousing their suspicion as to his mental
integrity, was to be suspected by his own relatives. Nor,
indeed, with the exception of my brother who had read my
suspiciously excellent letter, were any of my relatives dis¬
turbed, — and he did nothing to disabuse my assurance.

268

A MIND THAT FOUND ITSELF

After our night conference he left for his own home,
casually mentioning that he would talk with me again the
next morning. That pleased me, for I was in a talkative
mood and craved an interested listener.

When my brother returned the next morning I willingly
accepted his invitation to go with him to his office where
we could talk without fear of interruption. Arrived there,

I calmly sat down and prepared to prove my whole case. I
had scarcely “opened fire” when in walked a stranger a
strapping fellow, to whom my brother immediately intro¬
duced me. I instinctively felt that it was by no mere
chance that this third party had so suddenly appeared.
My eye at once lighted on the dark blue trousers worn by
the otherwise conventionally dressed stranger. That was
enough. The situation became so clear that the explana¬
tions which followed were superfluous. In a word, I was
under arrest, or in imminent danger of being arrested. 1 o
say that I was not in the least disconcerted would scarcely
be true, for I had not divined my brother’s clever purpose
in luring me to his office. But I can say, with truth, that I
was the coolest person in the room. I knew what I should
do next, but my brother and the officer of the law could only
guess. The fact is I did nothing. I calmly remained seated,
awaiting the verdict which I well knew my brother, with
characteristic decision, had prepared. With considerable
effort _ for the situation, he has since told me, was the most
trying one of his life — he informed me that on the preceding
day he had talked with the doctors to whom I had so thought¬
fully exhibited myself a week earlier. All agreed that
I was in a state of elation which might or might not
become more pronounced. They had advised that I be
persuaded to submit voluntarily to restraint and treatment,
or that I be forcibly committed. On this advice my brother

A MIND THAT FOUND ITSELF

269

had proceeded to act. And it was well so; for, though I
appreciated the fact that I was by no means in a normal state
of mind, I had not a clear enough insight into my condition
to realize that treatment under a certain amount of restraint
was what I needed — and that continued freedom might
further inflame an imagination already overwrought.

A few simple statements by my brother convinced me that
it was for my own good and the peace of mind of my rela¬
tives that I should temporarily surrender my freedom. This
I agreed to do. Perhaps the presence of two hundred pounds
of brawn and muscle, representing the law, lent persuasive¬
ness to my brother’s words. In fact, I did assent the more
readily because I admired the thorough, sane, fair, almost
artistic manner in which my brother had brought me to bay.

I am inclined to believe that, had I suspected that a re-com¬
mitment was imminent, I should have fled to a neighboring
State during the preceding night. The reader should not,
however, imagine that I was treated with any unnecessary
severity. The right thing in the right way was done at the
right time. Though up to this moment I had been the sub¬
ject of strategy, not for one moment thereafter, in any par¬
ticular, was I deceived. I was frankly told that several
doctors had pronounced me elated, and that for my own
good I must submit to treatment. I was allowed to choose
between a Probate Court commitment which would have
‘admitted me” (humorous phrase) to the State Hos¬
pital, or a “voluntary commitment” (somewhat humor¬
ous phrase) which would enable me to enter the large
private hospital where I had previously passed from de¬
pression to elation, and had later suffered tortures. I
naturally chose the more desirable of the two disguised
blessings, and agreed to start at once for the private hospital.

It was not that I feared again to enter the State Hospital, —

270

A MIND THAT FOUND ITSELF

I wished to avoid the publicity which necessarily would have
attended my commitment to that institution. Then, too,
there were certain privileges which I knew I could not
enjoy at the State Hospital, where doctors fear or refuse to
treat each case on its own merits. Having re-established
myself in society and business I did not wish to forfeit that
advantage; and as the doctors believed that my period of
elation would be short, it would have been sheer folly to
advertise the fact that my mental integrity had again fallen
under suspicion.

But before starting for the asylum I imposed certain con¬
ditions. One was that the man with authoritative trousers
should walk behind us at such a distance that no friend or
acquaintance who might see us would divine that I was
under guard; the other was that the doctors at the institu¬
tion should agree to grant my every request, no matter how
trivial, so long as it could in no way work to my own injury.
My privileges were to include that of reading and writing
to my heart’s content, and the procuring of such books and
supplies as my fancy might dictate. All this was agreed to.
In return I agreed to submit to the surveillance of an attend¬
ant when I went about the city. This I knew would con¬
tribute to the peace of mind of my relatives, wrho naturally
could not rid themselves of the fear that one so nearly sane
as myself might take it into his head to leave the State and
resist further attempts at incarceration. As I felt that I
could easily elude my keeper, should I care to escape, his
presence also contributed to my peace of mind, for I argued
that the ability to outwit my guard would atone for the
offense itself.

I then started for the hospital; and I went with a willing¬
ness surprising even to myself. A cheerful philosophy cn
abled me to turn an apparently disagreeable situation into

A MIND THAT FOUND ITSELF

271

one that was positively pleasing to me. I convinced myself
that I could extract more real enjoyment from life during
the ensuing weeks within the walls of a “retreat” than I
could in the world outside. My one desire was to write,
write, write. My fingers itched for a pen. My desire to
write was, I imagine, as irresistible as the desire of a drunk¬
ard for his dram. And the act of writing resulted in an
intoxicating pleasure composed of a mingling of emotions
that defies analysis.

That I should so calmly, almost eagerly, enter where
devils might fear to tread, may surprise the reader who
already has been informed of the cruel treatment I had for¬
merly received there. I feared nothing for I knew all. Hav¬
ing seen the worst, I knew how to avoid the pitfalls into
which, during my first confinement, I had fallen or delib¬
erately walked. I was confident that I should suffer no
abu^e or injustice so long as the doctors in charge should live
up to their agreement and treat me as a gentleman. This
they did, and my quick recovery and subsequent discharge
may be attributed mainly to this cause. The assistant
physicians who had come in contact with me during my first
experience in this hospital were no longer in charge. They
had resigned some months earlier — shortly after the death
of the former superintendent. Thus it was that I started
with a clean record, free from those prejudices which so
often bias the judgment of a doctor who has treated a
patient at his worst.

XXXIV

On more than one occasion my chameleon-like tempera¬
ment has enabled me to adjust myself to new conditions,
but never has it served me better than it did at the time
of which I write. A free man on New Year’s Day, enjoying
the pleasures of a congenial club-life, four days later I found
myself again under the lock and key of an asylum for the
insane. Never had I enjoyed life in New York more than
during those first days of that new year. To suffer so rude
a change was, indeed, enough to inspire a feeling of discon¬
tent, if not despair; yet, aside from the momentary initial
shock, my contentment was in no degree diminished. I
can say with truth that I was as complacent the very moment
I re-crossed the threshold of that “retreat” as I had been
when crossing and recrossing at will the threshold of my club.

Of everything I thought and did during the interesting
weeks which followed I have a complete record. The mo¬
ment I accepted the inevitable, I determined to spend my
time to good advantage. Knowing from experience that I
must observe my own case, if I was to have any record of
it, I provided myself in advance with note-books. In these,
from day to day, I recorded, I might almost say, my
every action, and every thought and fancy. The sane part
of me, which fortunately was dominant, subjected its tem¬
porarily insane and unruly part to a sort of scientific scru¬
tiny and surveillance. From morning till night 1 dogged
the steps of my restless body and my more restless imagina¬
tion. I observed the physical and mental symptoms which

272

A MIND THAT FOUND ITSELF

273

I knew were characteristic of elation. An exquisite light¬
heartedness, a slight ringing in the ears, the varying dilation
of the pupils of the eyes, my pulse, my weight, my appetite
— all these I observed and recorded with a care that would
have put to blush a majority of the doctors now working
among the insane.

But this record of symptoms, though minute, is vague
compared to my reckless analysis of my emotions. With a
lack of reserve characteristic of my sublime mood, I described
the joy of living, which, for the most part, then consisted of
the joy of writing. And, even now, as I re-read my record,
I feel that I cannot overstate the pleasure I found in sur¬
rendering myself completely to that controlling impulse.
The excellence of my composition seemed to me beyond crit¬
icism. And as, to one in a state of elation, things are pretty
much as they seem, I was able to experience the subtle de¬
lights which, I fancy, thrill the soul of a master. During
this month of elation I wrote words enough to fill a book
nearly as large as this one. Having found that each filling
of my fountain pen was sufficient for the writing of about
twenty-eight hundred words, I kept a record of the number
of times I filled it. This minute calculation I carried to an
extreme. If I wrote for fifty-nine minutes, and then read for
seventeen, that fact I recorded. Thus, in my diary and out
of it, I wrote and wrote, until the tips of my thumb and
forefinger grew numb. As this numbness increased, and
general weariness of the hand set in, there came a gradual
flagging of my creative impulse, until a very sane unproductiv¬
ity supervened. Thus I had and have now a safe mental
barometer and can judge my degree of normality — for no
one is absolutely normal — by the intensity of my desire to
write. This is fortunate; for surely he who can detect
an abnormal impulse in so innocent a manner, and correct
!9

274

A MIND THAT FOUND ITSELF

it when discovered, simply by writing it to sleep, is not likely
to experience more trouble in this world than he whose in¬
evitable ills present themselves in more conventional and
usually painful ways.

The reader may well wonder in what my so-called insan¬
ity at this time consisted. Had I any of those impracticable
delusions which had characterized my former period of
elation? No, not one — unless an unreasonable haste to
achieve my ambitions may be counted a delusion. My at¬
tention simply focused itself on my project. All other
considerations seemed of little moment. My interest in
business waned to the vanishing point. Yet, one thing
should be noted: I did deliberately devote many hours to the
consideration of business affairs. Realizing that one way
to overcome an absorbing impulse is to divide the attention,
I wrote a brief of the arguments I had so often presented to
bankers. In this way I was able to convince the doctors
that my intense interest in literature and reform would soon
spend itself.

A consuming desire to effect reforms had been the deter¬
mining factor when I calmly weighed the situation with a
view to making the best possible use of my impulse to write.
The events of the immediate past had convinced me that I
could not hope to interest men of wealth and influence in
my humanitarian project until I had some definite plan to
submit for their leisurely consideration. Further, I had
discovered that an attempt to approach these men directly
disturbed my relatives and friends who had not yet learned
to dissociate present intentions from past performances. I
had, therefore, determined to drill myself in the art of com¬
position to the end that I might write a story of my life
which would merit publication. I felt that such a book,
once written, would do its own work, regardless of my subse-

A MIND THAT FOUND ITSELF

275

quent fortunes. Other books had spoken even from the
grave ; why should not my book so speak — if necessary ?

With this thought in mind I began not only to read and
write, but to test my impulse in order that I might discover
if it were a genuine part of my being, an abnormal impulse,
or a mere whim. I reasoned that to compare my own feel¬
ings toward and for literature, and my emotions experi¬
enced in the heat of composition, with the recorded feelings
of successful men of letters, would give me a clue to the truth
on this question. At this time I read several books of a
nature that would have served as a basis for my deductions,
but only one of them did I have time to analyze and note in
my diary. That one was “Wit and Wisdom of the Earl of
Beaconsfield.” The following passages from the pen of
Disraeli I transcribed in my diary with occasional comments.

“Remember who you are, and also that it is your duty to
excel. Providence has given you a great lot. Think ever
that you are born to perform great duties.” This I inter¬
preted in much the same spirit that I had interpreted the
forty-fifth Psalm on a prior occasion.

“It was that noble ambition, the highest and best, that
must be born in the heart, and organized in the brain, which
will not let a man be content unless his intellectual power is
recognized by his race, and desires that it should contribute
to their welfare.”

“Authors — the creators of opinion.”

“ What appear to be calamities are often the sources of
fortune.”

Change is inevitable in a progressive country. Chanee

.s constant.” (“Then why,” was nty recorded comment,

cannot the changes I propose to bring about, be brought
about?”) 6

I he author is, as we must ever remember, of peculiar

276

A MIND THAT FOUND ITSELF

organization. He is a being born with a predisposition
which with him is irresistible, the bent of which he cannot
in any way avoid, whether it directs him to the abstruse
researches of erudition or induces him to mount into the
fervid and turbulent atmosphere of imagination.” “This,”

I wrote (and I wrote it the day after arriving at the hospital)
“is a fair diagnosis of my case as it stands to-day, assuming,
of course, that an author is one who loves to write, and can
write with ease, even though what he says may have no lit¬
erary value. My past proves that my organization is a pecul¬
iar one. I have for years (two and a half) had a desire to
achieve success along literary lines. I believe that, feeling
as I do to-day, nothing can prevent my writing. If I had
to make a choice at once between a sure success in the busi¬
ness career ahead of me, and doubtful success in the field of
literature I would willingly, yes confidently, choose the latter.
I have read many a time about successful writers who learned
how to write, and by dint of hard work ground out their
ideas. If these men could succeed, why should not a man
who is in danger of being ground up by an excess of ideas and
imagination succeed, when he seems able to put those ideas
into°fairly intelligible English ? He should and will succeed.”

Therefore, without delay, I began the course of experi¬
ment and practice which culminated within a few months
in the first draft of my story. Wise enough to realize
the advantages of a situation free from the anno\ing
interruptions of the work-a-day world, I enjoyed a degree
of liberty seldom enjoyed by those in possession of complete
legal liberty and its attendant obligations. When I wished
to read, write, talk, walk, sleep, or eat, I did the thing I
wished. I went to the theater when the spirit moved me to
do so, accompanied, of course, by an attendant, who, on
such occasions, played the role of chum.

A MIND THAT FOUND ITSELF

277

Friends called to see me, and at their own, or my
suggestion, I was invited for dinner outside the walls of my
“cloister.” At one of these dinners an incident occurred
which throws a clear light on my condition at the time. The
friend, whose willing prisoner 1 was, had invited a common
friend to join the party. The latter had not heard of my
re-commitment. At my suggestion, he who shared my
secret had agreed not to refer to my situation unless I first
broached the subject. There was nothing strange in the
fact that we three should meet. Just such impromptu cel¬
ebrations had before occurred among us. We dined, and,
as friends will, indulged in that exchange of thoughts which
bespeaks intimacy. After hours of delectable communion I
so shaped the conversation that a consideration of my
past experiences and the possibility of their recurrence fol¬
lowed. The uninformed friend derided the idea.

“Then, if I were to tell you,” said I, “that I am at this
moment supposedly insane — at least not normal — and
that when I leave you to-night I shall go direct to the very
hospital where I was formerly confined, there to remain until
the doctors pronounce me fit for freedom, what should you
sav?”

j

“I should say that you are a choice sort of liar,” he re¬
torted.

I his genial insult I swallowed with gratification. It was,
in truth, a timely and encouraging compliment, the force of
which its giver failed to appreciate until my host had corrob¬
orated my statements.

If I could so favorably impress an intimate friend at a
time when I was elated, it is not surprising that I should
subsequently hold an interview with a comparative stranger
— the cashier of a local bank — without betraying my con¬
dition. As business interviews go, this was in a class by

278

A MIND THAT FOUND ITSELF

itself. While my attendant stood guard at the door, I, a
registered inmate of an asylum, entered the banking room
and talked with a level-headed banker. And that inter¬
view was not without effect in subsequent negotiations
which led to the closing of a contract amounting to one
hundred and fifty thousand dollars.

The very day I re-entered the hospital I stopped on the
way at a local hotel and procured some of the hostelry’s
stationery. By using this in the writing of personal and
business letters I managed to conceal my condition and my
whereabouts from all except near relatives, and a few inti¬
mate friends who shared the secret. I quite enjoyed lead¬
ing this legitimate double-life. The situation appealed (not
in vain) to my sense of humor. Many a sly laugh did I in¬
dulge in when I closed a letter with such ambiguous phrases
as the following: “Matters of importance necessitate my re¬
maining where I am for an indefinite period.” . . . “A
situation has recently arisen which will delay my intended
trip South. As soon as I have closed a certain contract
[having in mind my contract to re-establish my sanity] I shall
again take to the road.” ... To this day few friends or
acquaintances know that I was in semi-exile during the
month of January, 1905. My desire to suppress the fact
was not due, as already intimated, to any sensitiveness regard¬
ing the subject of insanity. What afterwards justified my
course was that on regaining my freedom I was able, with¬
out embarrassment, again to take up my work. Within a
month of my voluntary commitment, that is, in February,
I started on business for the Central West and South where I
remained until the following July. During those months
I felt perfectly well, and have remained in excellent health
ever since.

This second and last hospital experience was most for-

A MIND THAT FOUND ITSELF 279

tunate. It came at a time and in a manner to furnish me
with strong arguments wherewith to support my con¬
tention that madmen are too often man-made, and that
he who is potentially a madman may keep a saving grip on
his own reason if he be fortunate enough to receive that
kindly and intelligent treatment to which one on the brink
of chaos is of right entitled. Though during this second
period of elation I was never in a mood so reckless as that
which obtained immediately after my recovery from depres¬
sion in August, 1902, I was at least so excitable that, had
those in authority attempted to impose upon me, I should
have thrown discretion to the winds. To them, indeed, I
frankly reiterated a terse dictum which I had coined during
my first period of elation. ‘‘Just press the button of Injus¬
tice,” said I, “and I’ll do the rest!” This I meant, for
fear of punishment does not restrain a man in the dare¬
devil grip of elation.

What fostered my self-control was a sense of gratitude.
The doctors and attendants treated me as a gentleman.
Therefore it was not difficult to prove myself one. But, had
they for one moment treated me as a criminal, or a dumb
brute, I should have resented their action as vigorously as I
had the action of their predecessors upon prior occasions.
Instead of regaining my normal poise and securing a com¬
plete freedom within a month, in all probability I should
have gone from bad to worse, lashing myself into a justifiable
fury that undoubtedly would have necessitated my being
confined for perhaps an indefinite period. Fortunately,
my case was treated on its merits. I was given individual
treatment. My every whim was at least considered with
a politeness which enabled me to accept a denial with
a highly sane equanimity. Aside from mild tonics I
took no other medicine than that most beneficial sort which

28o a mind that found itself

inheres in kindness. The feeling that, though a prisoner, I
could still command obligations from others, led me to rec¬
ognize my own reciprocal obligations, and was a constant
source of delight. The doctors, by proving their title to that
confidence which I tentatively gave them upon re-entering
the institution, had no difficulty in convincing me that a
temporary curtailment of privileges was for my own good.
They all evinced a consistent desire to trust me. In return
I trusted them. Nothing so well illustrates my proper
treatment, day in and day out, as the fact that I cannot now
recall a single denial of a request. Though not a few of my
requests were denied, my confidence, at the time, that the
denials were fair, has obscured the remembrance of them.
My case was a mild one; but I should have fought my way
again to freedom had I been met with that curt unreasonable¬
ness which characterized the attitude of the doctor who had
charge of me during my first period of confinement in
this hospital. Doctors and attendants who think it a thank¬
less task to attempt to gain the confidence and good-will of
a patient at the beginning of his confinement will do well to
ponder the contrast afforded by my actions during my first
and my last period of elation; and especially should they
remember that psychiatrists of wide expeiience and the
highest standing affirm that an elated or maniacal condition
is inevitably aggravated by unsound and tactless treatment.
Indeed, one authority with whom I discussed this point
went so far as to say that whether an elated patient shall
become a madman — and potential enemy 01 a faiih
obedient and interesting friend depends, in a majority of
cases, upon the capacity and attitude of the persons in
charge of him. This significant fact granted, are not the
hospital authorities largely responsible for the perpetuation
of the dread of institutions wherein the insane are confined,

A MIND THAT FOUND ITSELF

281

and will not this dread be kept alive until the thousands of
recoverable cases treated each year are so intelligently
cared for that, upon discharge, “ex-inmates” may speak
well, rather than ill, of an institution and the men in
authority ?

XXXV

On leaving the hospital and resuming my travels, I felt
sure that any one of several magazines or newspapers would
willingly have had me conduct my campaign under its ner¬
vously commercial auspices; but a flash-in- the-pan method
did not appeal to me. Those noxious growths, Incompe¬
tence, Abuse, and Injustice, had not only to be cut down, but
rooted out. Therefore, I clung to my determination to write
a book — an instrument of attack which, if it cuts and tears
at all, does so as long as the need exists. Inasmuch as I
knew that I still had to learn how to write I approached my
task with deliberation. I planned to do two things: first,
to crystallize my thoughts by discussion — telling the story
of my life whenever, in my travels, I should meet any person
who inspired my confidence; second, while the subject-
matter of my book was shaping itself in my mind, to drill my¬
self by carrying out a letter-writing campaign. Both these
things I did — as certain indulgent friends who bore the
brunt of my spoken and written discourse can certify. I
feared the less to be dubbed a bore, and I hesitated the less
perhaps to impose upon good nature, because of my firm
conviction that one in a position to help the many was him¬
self entitled to the help of the few.

I wrote scores of letters of great length. I cared little if
some of my friends should conclude that I had been born a
century too late; for, without them as confidants, I must
write with no more inspiring object in view than the w aste-
basket. Indeed, I found it difficult to compose without

282

A MIND THAT FOUND ITSELF 283

keeping before me the image of a friend. Having stipulated
that every letter should be returned upon demand, I wrote
without reserve — my imagination had free rein. I wrote
as I thought, and I thought as I pleased. The result
was that within six months I found myself writing with
a facility which hitherto had obtained only during ela¬
tion. At first I was suspicious of this new-found and appar¬
ently permanent ease of expression — so suspicious that 1
set about diagnosing my physical symptoms. My self-
examination convinced me that I was, in fact, quite normal.
I had no irresistible desire to write, nor was there any
suggestion of that exalting light-heartedness which character¬
izes elation. Further, after a prolonged period of composi¬
tion, I experienced a comforting sense of exhaustion which
I had not known while elated. I therefore concluded —
and rightly — that my unwonted facility was the product
of practice. At last I found myself able to conceive an idea
and immediately transfer it to paper.

In July, 1905, I came to the conclusion that the time for
beginning my book was at hand. Nevertheless, I found it
difficult to set a definite date. About this time I so arranged
my itinerary that I was able to enjoy two summer — though
stormy — nights and a day at the Summit House on Mount
Washington. What better, thought I, than to begin my
book on a plane so high as to be appropriate to this noble
summit? I therefore began to compose a dedication. “To
Humanity” was as far as I got. There the Muse forsook
me.

But, returning to earth and going about my business, I
soon again found myself in the midst of inspiring natural
surroundings — the Berkshire Hills. At this juncture Man
came to the assistance of Nature, and perhaps with an un¬
consciousness equal to her own. It was a chance remark

284

A MIND THAT FOUND ITSELF

made by an eminent man that aroused my subconscious
literary personality to irresistible action. I had long wished
to discuss my project with a man of deserved reputation,
and if his reputation were international, so much the better.
I desired the unbiased opinion of a judicial mind.
Opportunely, I learned that the Hon. Joseph H. Choate
was then at his summer residence at Stockbridge, Massa¬
chusetts. Mr. Choate had never heard of me and I had
no letter of introduction. The exigencies of the oc¬
casion, however, demanded that I conjure up one, so
I wrote my own letter of introduction and sent it:

Red Lion Inn,

Stockbridge, Mass.

August 18, 1906.

Hon. Joseph H. Choate,

Stockbridge, Massachusetts.

Dear Sir: —

Though I might present myself at your door, armed with one of society’s
unfair skeleton-keys — a letter of introduction — I prefer to approach you
as I now do: simply as a young man who honestly feels entitled to at least
five minutes of your time, and as many minutes more as you care to grant
because of your interest in the subject to be discussed.

I look to you at this time for your opinion as to the value of some ideas
of mine, and the feasibility of certain schemes based on them.

A few months ago I talked with President Hadley of Yale, and briefly out¬
lined my plans. He admitted that many of them seemed feasible and would,
if carried out, add much to the sum-total of human happiness. His only
criticism was that they were “too comprehensi\e. _

Not until I have staggered an imagination of the highest type will I ad¬
mit that I am trying to do too much. Should you refuse to see me, believe
me, when I tell you that you will still be, as you are at this moment, the un¬
conscious possessor of my sincere respect.

A MIND THAT FOUND ITSELF

285

Business engagements necessitate my leaving here early on Monday next.
Should you care to communicate with me, word sent in care of this hotel
will reach me promptly.

Yours very truly,

Clifford W. Beers.

Within an hour I had received the following reply:

Stockbridge, Mass.,
Friday evening.

Clifford W. Beers, Esq.,

Dear Sir: —

Your note of to-day rec’d. I will see you here for a few minutes to-mor¬
row morning at ten o’clock.

Yours truly,

Joseph H. Choate.

The next morning at ten o’clock, the door, whose lock I
had picked with a pen, opened before me and I was ushered
into the presence of Mr. Choate. He was graciousness
itself — but pointed significantly at a heap of unanswered
correspondence lying before him. I took the hint and within
ten minutes briefly outlined my purpose. After pronouncing
my project a “commendable one,” Mr. Choate offered the
suggestion that produced results. Said he: “If you will
submit your ideas in writing I shall be glad to read your
manuscript and assist you in any way I can. To fully con¬
sider your scheme would require several hours, and busy men
cannot very well give you so much time. What they can
do is to read your manuscript during their leisure moments.”

Thus.it was that Mr. Choate, by granting the inter¬
view, contributed to an earlier fruition of my plans. One week
later I began the composition of this book. My action was

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unpremeditated, as my quitting Boston for less attractive
Worcester proves. That very day, finding myself with a
day and a half of leisure before me, I decided to tempt the
Muse and compel myself to prove that my pen was, in truth,
“the tongue of a ready writer.” A stranger in the city, I
went to a school of stenography and there secured the ser¬
vices of a young man who, though inexperienced in his art,
was more skilled in catching thoughts as they took wing than
I was in the art of setting them free. Except in the writing
of one or two conventional business letters, never before
had I dictated to a stenographer. After I had startled him
into an attentive mood by briefly outlining my past career
and present purpose, I worked without any definite plan or
brief, or reference to data. My narrative was therefore
digressive and only roughly chronological. But it served
to get my material before my own eyes for future shaping.
At this task I hammered away three or four hours a day for
a period of five weeks.

It so happened that Mr. Choate arrived at the same hotel
on the same day with myself, so that some of the toil he had
inspired went on in his proximity, if not in his presence;
but I studiously kept out of his sight, lest he think me a
“crank” on the subject of reform, bent on persecuting his
leisure.

As the work progressed my facility increased — in fact, I
soon called in an additional stenographer to help in the snar¬
ing of my flying thoughts. This excessive productivity caused
me to pause and again to diagnose my condition. I could
not fail now to recognize in myself symptoms hardly dis¬
tinguishable from those which had obtained eight months
earlier when it had been deemed expedient temporarily to
restrict my freedom. But 1 had grown wise in adversity.
Rather than interrupt my manuscript short of completion 1

A MIND THAT FOUND ITSELF

287

decided to avail myself of a vacation that was due, and re¬
main without the borders of my native State — this, so that
well-meaning but perhaps over-zealous relatives might be
spared unnecessary anxiety, and I myself be spared pos¬
sible unwarranted restrictions. I was by no means certain
as to the degree of mental excitement that would result from
such continuous mental application; nor did I much care, so
long as I accomplished my task. However, as I knew that
“possession is nine points of the law,” I decided to main¬
tain my advantage by remaining in my literary fortress. And
my resolve was further strengthened by certain cherished
sentiments expressed by John Stuart Mill in his essay “On
Liberty,” — an essay which I have read and re-read with
an interest born of experience.

At last the draft was completed. After a timely remit¬
tance (for, in strict accordance with the traditions of the craft,
I had exhausted my financial resources) I started for home
with a sigh of relief. For months I had been under the
burden of a conscious obligation. My memory, stored with
information which, if rightly used, could, I believed, brighten
unhappy lives, was to me as a basket of eggs which it was my
duty to balance on a head whose poise was none too certain.
One by one, during the preceding five weeks, I had gently
lifted each thought from its resting-place, until my worri¬
some burden had been so shifted as to admit of its being
imposed upon the public conscience.

After I had lived over again the trials and the tortures
of my unhappiest years — which was of course necessary in
plowing and harrowing a memory, happily retentive — the
completion of the draft left me exhausted. But after a trip
to New York, whither I went to convince my employers
that I should be granted a further leave-of-absence, I re¬
sumed work. The ground for this added favor was that my

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A MIND THAT FOUND ITSELF

manuscript was too crude to submit to any but intimate ac¬
quaintances. Knowing perhaps that a business man with
a literary bee buzzing in his ear is, for the time, no business
man at all, my employers readily agreed that I should do as
I pleased during the month of October. They also believed
me entitled to the favor, recognizing the force of my belief
that I had a high obligation to discharge.

It was under the family roof- tree that I now set up my
literary shop. Nine months earlier an unwonted interest
in literature and reform had sent me to an asylum. That I
should now in my own home be able to work out my destiny
without unduly disturbing the peace of mind of relatives was
a considerable satisfaction. In the very room where, during
June, 1900, my reason had forsaken me, I re-dictated my
account of that reason’s experiences. It was concerning this
draft that I received a good while afterward the first of the
two letters from Professor William James of Harvard Uni¬
versity, which appear in the Introduction to this book.

My leave-of-absence ended, I resumed my travels eagerly;
for I wished to cool my brain by daily contact with the more
prosaic minds of men of business. I went South. For a
time I banished all thoughts of my book and project. But
after some months of this change of occupation, which I
thoroughly enjoyed, I found leisure in the course of wide
travels to take up the work of revision. My hours of leisure
I devoted more, however, to reading than to writing. The
“excess baggage” which at times I had to pay, was occa¬
sioned by what I irreverently called “several pounds of rhet¬
oric.” For, though Professor James had paid me the
compliment of advising me not to re-write my story, I fear
his advice must have been prompted by a doubt as to my
ability to improve my composition, rather than the convic¬
tion that my crude draft was an excellent performance.

A MIND THAT FOUND ITSELF

289

That draft I submitted to all sorts and conditions of
mmds (in accordance with Mill’s dictum: that only in that
waj can the truth be obtained). And it is at this point in
my narrative, rather than in the dusty comers of the usual
preface, that I wish to express my obligation to one critic
and helper — my former school- fellow, Mr. Herbert Wescott
Fisher. It was he who led me to see my need of technical
training, neglected in earlier years. To be exact, however,
I must confess that I read rather than studied rhetoric.
Close application to its rules served only to discourage me,
so I but lazily skimmed these worthy works. But my re¬
discovered friend did more than direct me to sources. He
proved to be the kindly mean, between the two extremes
of stranger and intimate. I was a prophet not without honor
in his eyes. Upon my embarrassing wealth of material he
brought to bear his practical knowledge of the workmanship
of writing. My debt to him, in which the reader is a
sharer, is almost beyond repayment. Scarcely a paragraph
in this book is not the better for his direct touch. And
my own drafting of the later parts has been so improved
by the practice I have received under his scrupulous direction
that he has had little fault to find with them.

Nothing would please me more than to express specifically
my indebtedness to many others who have assisted me in the
preparation of my work. But, aside from calling attention
to the fact that the managements of the two hospitals so
fully discussed have exhibited rare magnanimity (even going
so far as to write letters which have helped me in my work),
and, further, acknowledging anonymously (the list is too long
for explicit mention) the invaluable advice given me by scien¬
tists who have made my work authoritative, I must be content
to indite an all-embracing acknowledgment. Therefore, and

with distinct pleasure, I hereby emphasize the fact that the
20

290

A MIND THAT FOUND ITSELF

active encouragement of casual but trusted acquaintances,
the inspiring indifference of unconvinced intimates, and the
kindly scepticism of indulgent relatives, who, perforce, could
do naught but obey an immutable law of blood-related
minds, — all these influences conspired to render more sure
the accomplishment of my heart’s desire.

And now the reader nears the end of my life-story.
But, before closing this intimate part of my pica for justice
long-delayed, I feel that it is my privilege, as it is my duty,
to impress upon the reader that he has, unconsciously per¬
haps, assumed part of the burden which in the very telling
of my story I have shifted to the shoulders of the many.
If the reader does not now feel that he would like to do
something to help those unfortunates for whom I speak,
then either I have failed to present my story convincingly,
or the reader’s love of fair play and his moral nature are
of a false kind.

PART IV

XXXVI

One in telling such a story as mine owes it to the public
to offer a feasible remedy for the evils disclosed. Especially
is he under obligation to the relatives and friends of the
insane, for a description of heart-rending conditions, offered
without hope of correction, cannot but be painful to those
most vitally interested in the problem. My obligation in
mind, I have spared no effort to make this book authoritative.
Alienists, psychologists, neurologists, pathologists, hospital
officials, practical sociologists and organizers have been con¬
sulted. Indeed, as many as fifty persons, representing the
more important activities of life, have read my work — in
part or entirety while it was in manuscript or the form of
printed proof; and a goodly number of this small army of
critics and advisers have found such delight in using the
blue pencil of correction that I may now present my book and
project with a sense of security which can come only to one
whose work has been tried by fire — in private. To these
unnamed critics my debt (and the reader’s, I believe) is
very great.

By this time two paramount questions have no doubt arisen
in the mind of the reader: First, is there in the problem of
managing and treating the insane an inherent difficulty which
will forever prevent the correction of such abuses and defi¬
ciencies as have been discussed in this book? Second, if not,
how may the individual assume part of the burden which in

the telling of my story has been shifted to the shoulders of
the many?

2QI

292

A MIND THAT FOUND ITSELF

An emphatic answer to the first question may be given.
No inherent difficulty stands in the way of the universal cor¬
rection of all abuses and deficiencies of treatment complained
of in this book — unless it be the inherent apathy of a pub¬
lic which for centuries has failed to do its duty by the insane.
Proof of the soundness of this conclusion may be found in the
fact that at this moment an encouraging number of our
hospitals for the insane are so ably managed that abuses,
common in the poorly managed ones, rarely occur in institu¬
tions of the approved class. Freedom from the supposedly
inevitable evils complained of may usually be traced and
rightly attributed to the character and capacity of the man
at the head of a given hospital. A high-minded, efficient
superintendent, regardless of the apathy of the public, the
costly economy of ill-informed legislators, or inadequate,
even crude, material equipment of the hospital itself, may
so conduct his institution as to protect his insane wards
against physical abuse, indignities, and what, in so man)
cases, amounts to criminal neglect of patients scarcely able
to help themselves.

Surely the situation is by no means hopeless, so long as a
superintendent of the right type can (almost single-handed)
overcome a sufficient number of the inevitable difficulties
to raise the standard of treatment in his institution to a
humane level. For, if the efficient few, working under such
unfavorable conditions as obtain generally to-day, can con¬
vert their respective hospitals into the semblance of model
ones, how absurd to contend that there can be found among
the more than one hundred thousand physicians in this
country, fewer than four hundred men capable of assuming
the responsibilities of a superintendency? When intelligent
and non-political care in the selection of superintendents
shall be rigorously and universally exercised, then, threats,

A MIND THAT FOUND ITSELF

293

curses, camisoles, mufls, straps, unwarranted seclusion, il¬
legal exile and physical abuse in general will take their be¬
lated place in history along with the horrors of the Dark Ages.

For bringing about the reforms which, of necessity, must
precede any such correction of century-old abuses, the in¬
terest of every right-thinking person in this country must be
enlisted. Few, indeed, are endowed with great riches. Few
are able to convert their best impulses into an acceptable
medium of exchange. But every man and woman can lend
a hand, or at least speak a word. Our subject has for gen¬
erations been neglected. It is the discussion of it that will
create and mold Public Opinion, and Public Opinion, vig¬
orously expressed, will, more than any other factor, tend to
correct the evils I have denounced. Has my story utterly
failed of its purpose? If it has stirred your sympathy it is
your duty to give expression to this aroused interest, not to
me, but to everybody within your sphere of influence. Con¬
tinual and sincere expression will wear away that rock of
indifference against which the distressed souls and abused
bodies of the insane have been bruised for centuries. Has
my story not as the story of my life, but as representing
the experiences of thousands of others still living and of
thousands whose terrible secrets died with them — has this
story , I say, aroused within you the healthy desire to con¬
tribute at least your influence to the corrective and over¬
whelming force of Public Opinion? If so, your duty is
plain.

Individual assistance may be given in an easy way.
Let each convinced reader of this book become a member
of whatever “Society,” “Association” or “Committee,”
may be organized in his state when the necessity for its
existence has been brought home to the public. Thus, for
the first time in history, legislators throughout the land

2Q4

A MIND THAT FOUND ITSELF

will have impressed upon them the fact that the public
desires hospital managements to have support — such
support as will enable them to discharge their obligations
to the public — and discharge them in a manner that
will bring credit, not disgrace, to a nation distinguished
for its love of fair play.

If the individual may be enlisted in the work of reform,
so may the Federal Government, for the principal busi¬
ness and justification of government is the protection of
the weak against the strong, and, naturally, there are some
things which the Federal Govermnent can do better than
any other agency. Everyone knows that through its
Department of Agriculture this nation each year expends
many thousands of dollars in economically sound endeavors
to exterminate the parasites which prey upon valuable
plant and animal life. To annihilate the gypsy-moth in
Massachusetts and the cattle-destroying tick in Texas,
fortunes have been spent. All crops, except the crop upon
which prosperity itself depends — the brain crop — have
received, or are about to receive, their due protection at
the hands of the Govermnent. Yet, generation after gen¬
eration, the health of men’s minds has been neglected.

At this point in the first edition of this book I suggested
that “an effective beginning might be made if the Govern¬
ment would establish a Federal Commission for the ade¬
quate statistical investigation of insanity.” A better plan
has since been evolved, largely as a result of the growth of
interest in organized work in mental hygiene. A bill pro¬
viding for a Division on Mental Hygiene as an integral
part of the United States Public Health Service passed
the House in 1916, but has not yet been voted upon by the
Senate. This bill should be passed without delay, so that
the Government may begin to do its share in helping to

A MIND THAT FOUND ITSELF

295

conserve the mental health of the Nation — an asset second
to none in importance.

Though the “national society” recommended in the
first edition of my book has been established and is de¬
scribed in detail in Part V, the following paragraphs, in
which the plan was first presented, are retained in this
revised edition as they show the origin of what is now
known as the mental hygiene movement.

A permanent agency for reform and education in the
field of nervous and mental diseases is one of the great
needs of the day. Such an agency — whatever its form —
could do in its own field what the National Association for
the Study and Prevention of Tuberculosis has done, and
is doing, in its sphere of activity. Though the improve¬
ment of conditions among the insane should ever be an
important factor in shaping the policy of such an organi¬
zation, its most important work would be the waging of
a campaign against the prevailing ignorance regarding
insanity. To cure the disease by preventing it, is the best
cure known. The watchword of such an organization
might well be Mental Hygiene, the purpose of which is
the spreading of a common-sense gospel of right thinking
in order to bring about right living. This knowledge is
needed by the public at large if the population of our
institutions is to be controlled and eventually decreased.
A campaign of education, rigorously carried on, would, in
time, lead to the rescue of thousands who, if left in igno¬
rance, must, of necessity, drift into a state of actual and
perhaps incurable insanity. Editors, ministers, educators,
philanthropists, and members of the medical profession,
could do much to further such a work of enlightenment.

2g6

A MIND THAT FOUND ITSELF

Having promised the reader a “remedy,” I dare to offer
a definite recommendation, based on the advice of interested
supporters who, for years, have been actively engaged in
successful works of reform and education. I suggest that a
“National Committee” (modeled after the very efficient
“National Child Labor Committee”) shall, without delay,
be brought to a working perfection. Such a “Committee”
could co-operate with Federal, State, and local agencies —
and do so in such a manner that representative men and
women in each State may, when it takes shape, control the
movement in their respective communities.

The ramifications of the proposed organization would
be so numerous as not to admit of detailed description
here. Suffice it to say that the “National Committee for
Mental Hygiene” (I present the name for consideration)
would be equally the friend of the physician and the patient;
also the friend of a patient’s relatives, to whom, when
burdened with an actual or impending affliction, it would
become an unfailing source of information, advice, and
comfort. In a word, it would be a friend to Humanity,
for no man knows when he himself may have to look to
it for assistance.

XXXVII

The history of the development of Non-Restraint is in¬
tensely interesting, but too long a story to admit of its incor¬
poration in this book. However, the reader may gain a
comprehensive idea of the inception of this humane principle,
its scientific value and practicability, if he will but turn to
Appendix I and read the opinion of an earnest believer
in Non-Restraint, Dr. Charles W. Page, former Superin¬
tendent of the Danvers State Hospital for the Insane, at
Hathorne, Massachusetts. A superintendent of wide ex¬
perience, he testifies that since deliberately introducing Non-
Restraint, “I have been responsible for the custody and
treatment of more than six thousand insane persons, not
one of whom was restrained with mechanical appliances by
my orders or within my knowledge.” How, then, can any
superintendents, worthy of support, continue to use apolo¬
getically that cruel method which they dare not freely
advocate? The mere fact that their attitude is apologetic
proves that these unprogressive men (to use a mild term) can
be converted, provided Public Opinion will do its right
work.

Though the universal adoption and continued use of Non-
Restraint will contribute to the well-being, even happiness,
of the inmates of our hospitals, its use alone cannot materially
decrease the total number of insane persons, except in so far
as the resulting recoveries will more than offset the average
greater number of years a patient is likely to live in an insti¬
tution where he is treated kindly and scientifically from

397

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A MIND THAT FOUND ITSELF

the moment of commitment. Of course, if, in a supposedly
humane age, it is the policy of the public to treat the unfor¬
tunate insane harshly, even brutally, with the hope of killing
some and cutting short the lives of others, destined to live
long under favorable conditions, Restraint is the method of
treatment to use, and the more cruel and repressive it is, the
easier will it be for some cold-blooded calculator to prove
that by its means, money has been saved the State. But
it will be at the cost of killing many patients who might
recover; and, further, such an accountant in arriving at
his heartless result would certainly have to disregard the
economically sound law that it is cheaper for the State
to spend any amount of money for the prevention and
cure of insanity than it is to neglect those threatened or
afflicted with it.

It is evident, therefore, that insanity, if it is ever to be con¬
quered, must be attacked along lines not commonly followed
to-day. As to the method of attack to adopt there can be no
argument, for the masters of medical education in every
country on the continent of Europe have proved the prac¬
ticability and value of the plan in question. What is needed
in order to reach the root of the problem of insanity is the
establishing of so-called Psychiatric or Psychopathic Hos¬
pitals in connection with our Medical Schools, — hospitals
wherein nervous and mental diseases may be treated in the
most scientific manner, not only for the benefit of the
patients, but also for the benefit of physicians and stu¬
dents. What a leap forward in humanitarian endeavor
it would be if each university, so situated and organ¬
ized as to warrant it, should have under its everlasting
protection a modern Psychopathic Hospital! (Have not
seats of learning outlasted seats of government?) And
what could be more appropriate than the restoration

A MIND THAT FOUND ITSELF 299

of lost reasons under the hospitable protection of the very
institutions wherein reason itself is trained to do its right
work? Thus will it become possible to instruct the medical
profession generally in psychiatry or psychopathology — a
branch of medicine about which thousands of physicians
know little, — or, in many instances, nothing at all. In
addition, numberless persons threatened with mental col¬
lapse, or actually insane, will then receive the benefit of
prompt and scientific treatment at a time when the mental
life of the afflicted one hangs in the balance. Further,
Psychopathic Hospitals will enable scientists to study insan¬
ity; and such institutions, by setting a high standard, will
soon raise the standard of treatment throughout the country.

The necessity for such modern hospitals may be appre¬
ciated when an accredited authority in this country on
matters pertaining to medical education (Dr. William H.
Welch of Johns Hopkins University) can say, as he did to
the writer of this book: “The most urgent need in medical
education in America, to-day, is the need of Psychiatric
Clinics (Psychopathic Hospitals) where medical students,
and physicians as well, may benefit by instruction in psy¬
chiatry, and where scientific research into the cause and cure
of insanity may be carried on unceasingly.”

When the fact is considered that each university in Ger¬
many, France, Italy, Switzerland, Austria, Russia, Norway,
Sweden, Denmark, Holland, Belgium, Brazil, Argentine
Republic and Japan, at the present time, has a psychiatric
clinic under its own control, and that no physician in most
of these countries may practice medicine until he has passed
a satisfactory examination in psychiatry, the disgraceful
state of affairs existing in this, the richest nation in the world,
may be the more readily appreciated. In Germany a
system of state-supported sanatoriums has long been in

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A MIND THAT FOUND ITSELF

successful operation. These institutions, however, are not
open to those afflicted with a developed mental disease.
They are designed for the exclusive use of those threatened,
with mental collapse. The Germans engage in the rescu¬
ing of those threatened with insanity because they have
been wise enough to realize that it is cheaper to help the
individual back to health than to let him break down com¬
pletely and live, perhaps for years, a burden on the State.

In the light of such embarrassing facts, it is indeed
high time that the United States of America should
prove itself the vauntedly progressive nation it is sup¬
posed to be, by taking hold of the neglected problem
of insanity, and, through its several State Legislatures,
bringing into existence Psychopathic Hospitals of the type
described in the interesting U. S. Consular Report on
the Munich Clinic, quoted in full in Appendix II. That
the movement toward the erection of such model hos¬
pitals is already under way is a fact, and those who know the
field predict that within five years a majority of the States
will be operating institutions of the desired type, and that
within a decade no State will be without at least one Psycho¬
pathic Hospital of its own.1 Thus far, Michigan is the only
State in the Union to erect a modern Psychopathic Hos¬
pital. New York, however, has taken steps toward the
erection of one, a well-meant though totally inadequate
appropriation having been voted for the purpose.2

1 In the year 1906, at a cost of about $75,000, a hospital of this type was
brought under the control of the University Hospital at Ann Arbor, Michi¬
gan. Because of the close relations existing between the State authorities
and those of the University (of Michigan), this new institution, though
virtually a part of the University, is at the same time a part of the system
of State Hospitals.

2 If this State will appropriate, say, $1,000,000 instead of the com¬
paratively paltry $300,000 previously voted, New York City will have

A MIND THAT FOUND ITSELF

3°i

As the location of this particular type of hospital is of
vital importance, I shall here venture to emphasize an
underlying principle which cannot be safely ignored when
the selection of a site for such an institution comes up
for decision. After discussing this subject with alienists,
superintendents and assistant physicians of hospitals for
the insane, and with certain recognized authorities on
the needs of the insane, I am led to the sure conclusion
that Psychopathic Hospitals erected at the expense of the State
should be made a part of the existing hospital system. No
State Hospital can hope to fulfil its functions properly until
it has under its control, and within easy reach — that is,
within the hospital confines — a separate building erected
for the purpose of treating acute cases of insanity, either
newly-admitted ones, or so-called chronic cases during
recurrent, acute periods of depression or excitement. Pa¬
tients of the latter class are numerous in our large hospitals,
and when a management, because of inadequate equipment,
has to treat such cases in the wards with patients less dis¬
turbed, a great injustice is done not only to the “acute cases”
but to all other patients who are forced to live in the same
ward with them. Failure on the part of those in authority
to provide each State Hospital for the Insane with a Psycho¬
pathic Hospital or Pavilion (by which is meant a separate
building, or group of small buildings) will bring about
a result which it is painful even to contemplate; for the mo¬
ment the Psychopathic Hospital is set apart as a favored type
of institution, that moment will the State Hospitals or asy¬
lums, so-called, sink — in the estimation of the public — to
a level far below the level of the worst managed asylum
at present in existence. To adopt a policy which would

what it so richly deserves — a modern hospital as good as the one at
Munich.

3°2

A MIND THAT FOUND ITSELF

widen the already great gulf that exists between gen¬
eral hospitals and asylums would undo in a day the work
of a century. I have criticised with a considerable, yet mer¬
ited, severity, our State Hospitals for the Insane; neverthe¬
less, these two hundred and odd hospitals, erected at a cost
to the Nation of over one hundred millions of dollars, con¬
stitute the nucleus of what will, in time, — if rightly man¬
aged — become the most perfect hospital system in the world.
Continue to force the several managements to minister to
the insane with hospitals which lack that most essential
remedial feature, the Psychopathic Pavilion, and the dread
of insanity and asylums which of late years (I am thankful
to be able to record) has grown noticeably and hope¬
fully weaker, will not only be perpetuated — it will be
cruelly and needlessly intensified! But let the many States
in the Union which shall erect Psychopathic Hospitals
during the ensuing decade make a beginning by adding to
our existing asylums adequate treatment divisions, and the
present dread of insanity, and the dread of asylums, will, in
a relatively short time, be reduced to an intelligent minimum.
Then ordinary asylums, instead of continuing to rank as
mere prison-houses, will rise to the level of the best of our
general hospitals, and eventually they will become a source
of justifiable pride to the Nation.

I would not have it thought that I favor the building of
Psychopathic Hospitals only where they may be brought
under the control of a state hospital already established.
My advice in that connection had to do only with appropri¬
ations that shall be made during the next few years by State
Legislatures. When it comes to philanthropic work that
may be done by individuals of vast wealth, or by bodies of
public-spirited men and women for the benefit of their re¬
spective communities, the suggestion 1 have to make is quite

A MIND THAT FOUND ITSELF

3°3

different. At first, money secured from private sources
should go toward the building and endowing of Psycho¬
pathic Hospitals, which preferably may be brought under
the control of those universities which have medical de¬
partments.

Cities where there are universities, and the larger and
wealthier cities throughout the country, will before long have
such institutions; but the smaller cities — even some having
from one hundred to three hundred thousand inhabitants —
will be unable to secure or maintain independent Psycho¬
pathic Hospitals. As each community owes it to itself to
make provision for the prompt treatment of cases of incipient
insanity, and thus spare the individual the ordeal of commit¬
ment as an incompetent, it is fortunate that relief is at
hand for such cities as cannot maintain a modern Psycho¬
pathic Hospital. Here the so-called General Hospital may
be put to full use. Separate buildings, or pavilions, may
be erected and maintained at comparatively slight cost, as
has already been proved by the success of the Psychopathic
Hospital at Ann Arbor, Michigan. That is to say, for con¬
siderably less than $100,000 an efficient department of Men¬
tal and Nervous diseases may be organized and brought
under the control of any well managed General Hos¬
pital. Though there is but one General Hospital in the
country where this problem has been worked out, the results
of what five years ago was an experiment have justified the
rather startling venture made by the pioneer in this impor¬
tant work.1 Dr. J. Montgomery Mosher, Specialist in Ner¬
vous and Mental Diseases at the Albany Hospital, Albany,

1 At Bellevue Hospital (New York City) cases of insanity are received and
held pending examination and transfer. As few patients remain longer
than five days in this Psychopathic Ward, the ward becomes little more than
a clearing-house for trouble — not an agency for cure.

3° 4

A MIND THAT FOUND ITSELF

N. Y., is the man who has had the courage and good sense
to go ahead and prove that a General Hospital should and
can receive and treat mental diseases as successfully as the
diseases which are now treated without question in such
institutions. In Pavilion F, at the Albany Hospital, remark¬
able results have been obtained during the five years it has
been in operation. This is proved by a passage from an
address by Dr. Mosher delivered before the 34th National
Conference of Charities and Corrections at Minneapolis,
Minnesota, June 18th, 1907. He says:

“From February 18th, 1902, the day of the first admission,
to February 28th, 1907, one thousand thirty patients have en¬
tered the building (Pavilion F). Of these five hundred and
ninety-six have returned to their homes recovered and im¬
proved; three hundred and sixteen have remained stationary,
and eighty-six have died. Two hundred and forty-five
have been transferred to institutions for the insane; of these,
one hundred and twenty-six were sent to Pavilion F for
detention during the legal proceedings, and one hundred and
eighteen were committed after a period of observation. It
thus appears that nine hundred and five patients have been
under treatment without legal process, one hundred and
eighteen of whom it became necessary to commit later to
institutions for the insane.

“If this special provision for the treatment of the mentally
deranged had not been made in the Albany Hospital, then
these nine hundred and eight patients would either have had
to be improperly treated at home, or would have been com¬
mitted after a probably harmful development of the disease.
It is impossible to judge how many have been saved from an
unnecessary commitment.”

I urge the reader to turn to Appendix III where he
will find Dr. Mosher’s address in full. It will prove that

A MIND THAT FOUND ITSELF

3°5

General Hospitals throughout the country should begin
to receive and treat nervous and mental diseases as is
now being done with success at the General Hospital at
Albany.1

1 During recent years several new Psychiatric Clinics, Psychopathic
Hospitals and special Pavilions or wards for the treatment of mental disease
have been established or planned.

The Phipps Psychiatric Clinic at Baltimore, of which Dr. Adolf Meyer
is Director, was given to Johns Hopkins Hospital and University by Mr.
Henry Phipps of New \ ork. All told, his gift is said to have amounted to
more than one million dollars, the largest gift ever made by an individual in
this country for the study and treatment of cases of mental disorder. As
many such institutions are needed in the United States, it is hoped that
other public-spirited citizens of wealth will follow the lead of Mr. Phipps
in the field mentioned.

The Boston Psychopathic Hospital, of which Dr. E. E. Southard is
Director, was erected and is maintained by the State of Massachusetts,
as a part of its system of State Hospitals. It is, however, a separate insti¬
tution, built near the Harvard Medical School, with which, at least with
respect to its teaching facilities, it is closely allied.

In noting the increase in the number of Psychiatric Clinics, viz., the ones
at Baltimore and Boston, mention also should be made that an encouraging
increase is shown in the number of Psychopathic Wards, or Pavilions, now
in operation, or planned for, in connection with general hospitals.

91

XXXVIII

Given Psychopathic Hospitals and “Mental Wards” or
“Pavilions” at our General Hospitals, there still remains
another type of institution to be added if patients with a
chance for recovery are to receive the treatment they deserve.
Statistics show that twenty1 per cent of those who recover
from an attack of insanity recover after having been con¬
fined in a hospital or asylum for a year or more. Obviously,
recoverable cases cannot remain for that length of time in a
Psychopathic Hospital or in a “Mental Ward” in a General
Hospital. The hospital or “Pavilion” with a limited num¬
ber of beds (and it will be many years before there are a
sufficient number of Psychopathic Hospitals to supply the
demand for accommodations) must, of necessity, keep its
population moving if the acute cases occurring every day
are to be received and given treatment at a time when the
lives — mental fives, at least — of the afflicted ones hang in
the balance. To make room for new cases, the hopeful
and convalescent cases must be transferred to the homes of
the patients — there to disorganize and distress the house¬
holds; or they must be transferred to an asylum; or, provided
the expense can be borne, transferred to a private hospital
or sanatorium. This state of affairs lays bare a fault which
should be corrected without delay. It is evident, therefore,
that an intermediate type of institution state-supported,
co-operatively managed, or endowed, should be brought
into the field.

Here the model sanatorium — a place of considerable

3°6

A MIND THAT FOUND ITSELF

307

freedom — should intervene. In time the several States
(following the enlightened example of Germany) will
no doubt erect such institutions, but so much remains
to be done by the States in the way of improving existing
State Hospitals and asylums that the immediate creation of
these indispensable adjuncts to a perfect hospital system
must be undertaken by public-spirited citizens, possessed of
wealth and the impulse to spend it for the good of those
less fortunate. If one man, Mr. D. O. Mills of New
York, may erect and operate, at a fair return on his in¬
vestment, hotels which provide self-respecting poor with
wholesome surroundings and good food, and still charge
only nominal rates for the accommodations, why may
not philanthropy and business be likewise combined for
the benefit of those threatened with nervous or mental
collapse? This class would include those who, after treat¬
ment in a Psychopathic Hospital, must continue treatment
of some kind for the few months which will elapse be¬
fore they are again in condition to engage in gainful
occupation. In suggesting that the “Mills Hotel Plan”
be applied to the sanatorium field, I think I am on safe
ground; and I trust that individuals of wealth will turn
their attention to a field so rich in possibilities that it may be
worked at a profit that can be measured not only in money,
but in sendee to mankind.

Perhaps, if I give an added chapter of my experiences,
those in a position to correct a great evil will be the more
ready to undertake the work.

XXXIX

The particular evil I have referred to at the end of the
preceding chapter is the heartless way in which many owners
of private hospitals and sanatoriums take advantage of
people in distress. Knowing that the relatives of an
insane person will seldom place him in a public insti¬
tution until their resources are completely exhausted, these
owners proceed to drive almost as sharp a bargain as they
would were they trading horses with a known trickster.
The desire to succor distressed relatives is an emotion
scarcely known to this type of man. Commercialism, not
philanthropy, is his passion. “Pay the price or place
your relative in a public institution!” is the burden of his
discordant song before commitment. “Pay, or get out!” is
his jarring refrain when satisfied that he has exhausted the
family resources.

Though I am well within my rights in criticising the qual¬
ity of heart exhibited by typical owners of such institutions
as are run for personal gain, it is only fair to point out that
this hardness of heart of the individual is but a chip off the
stumbling-block of public apathy. So long as the public
refuses or neglects to establish hospitals where the insane
may receive the best of treatment at minimum cost, is it
reasonable to expect individuals to invest fortunes in a re¬
sponsible and irksome work unless they see the chance to
extort an unfair return? Assuredly not. In fact, these
owners, by much and continued thought, have tricked them¬
selves into the belief thett they are indeed public benefactors

308

A MIND THAT FOUND ITSELF

309

— wherein they are not entirely wrong, for they have, in a
measure, filled the gap that exists in our hospital system of
to-day.

Do you imagine that I speak with undue severity? Let
me then refer to certain hitherto unrecorded incidents in my
own life. They occurred while I was an inmate of a private
sanatorium of the type condemned. The institution in
question, though by no means deserving of rank among the
best, is one of the largest of its kind in this country. From
a modest beginning, made not many years ago, it has en¬
joyed a mushroom growth, and to-day harbors about two
hundred and fifty unfortunates. Its material equipment is
cheap. It is composed of a dozen or more small frame build¬
ings, suggestive of a mill settlement. Outside the limits of
a city, and in a State where there is no official supervision
worth mentioning, the owner of this little settlement of woe
has erected a nest of veritable fire-traps. Within these the
most helpless of all mankind are forced to risk lives which
may, or may not, again be of real value. This is a dangerous
economy, but it is of course necessary if the owner is surely
to grind out an exorbitant interest on his investment.

The same spirit of economy pervades the entire institu¬
tion. Its worst manifestation is in the employment of
the meanest type of attendant. In a State Hospital for the
Insane there is perhaps some slight excuse for limiting the
remuneration of attendants, for there the appropriation for
maintenance per week is limited usually to three or four
dollars for each of the patients. But, in private sana-
toriums, where the average minimum charge per week is,
as a rule, twenty or twenty-five dollars, and where many
patients pay forty or fifty dollars or more, there is no excuse
for an economy so pernicious. The owner of such a gold
mine cannot honestly plead that a lack of funds forces

3IQ

A MIND THAT FOUND ITSELF

him to employ attendants who are willing to work for a
paltry eighteen dollars a month — $4.50 per week — a wage
which kitchen servants frequently refuse to accept. Occasion¬
ally a competent attendant consents to work here when there
is a scarcity of profitable employment elsewhere. Witness
the young man who, shortly after my arrival at this private
institution, providentially (for me) sought and secured a
position. He received only eighteen dollars a month at the
beginning; the sixth and last month of his employment there
he received the same meager wage. This man, so long as
he remained in the good graces of the owner-superintendent,
was admittedly one of the best attendants he had ever had.
Yet aside from a five-dollar bill which a relative had sent me
at Christmas and which I had refused to accept because of
my belief that it, as well as my relatives, was counterfeit —
aside from that, this competent attendant and charitable
friend received no additional rewards. His chief reward lay in
his consciousness of the fact that he was protecting me against
injustices which surely would have been visited upon me had
he quitted his position and left me to the mercies of the owner
and his ignorant assistants. To-day, with deep apprecia¬
tion, I often contrast the treatment I received at his hands
with that which I suffered during the three weeks preceding
his appearance on the scene. During that period, not fewer
than seven attendants contributed to my misery. Though
some of them were perhaps decent enough fellows outside
a sick-room, not one had more right to minister to a man
in my condition than has a butcher to perform delicate
operations in surgery.

The two who first attended me did not strike me with
their fists or even threaten to do so; but their unconscious
lack of consideration for my comfort and peace of mind
was torture. They were typical eighteen-dollar-a- month at-

A MIND THAT FOUND ITSELF

3 II

tendants. Another attendant of the same sort, on one occa¬
sion, cursed me with a degree of brutality which I prefer not
to recall, much less record. And a few days later the climax
was appropriately capped when still another eighteen-dollar-
a-month attendant perpetrated an outrage which a sane
man would have resented to the point of homicide. He was
a man of the coarsest type. His hands would have done
credit to a longshoreman — fingers knotted and nearly twice
the normal size. Because I refused to obey a peremptory
command, and this at a time when I habitually refused on
pain even of imagined torture to obey or to speak, this brute
not only cursed me with abandon, he deliberately spat upon
me. I was a mental incompetent, but like many others in
a similar position, I was, both by antecedents and by train¬
ing, a gentleman. Vitriol could not have seared my flesh
more deeply than the venom of this human viper stung my
soul! Yet, as I was rendered speechless by delusions, I could
offer not so much as a word of protest. I trust that it is not
now too late, however, to protest in behalf of the thousands
of outraged patients in private and State hospitals whose
mute submission to such indignities has never been recorded.

If the owner-superintendent of this particular sanatorium
were brought to book for such offenses, what excuse would
he offer ? A hundred to one he would enter the evasive
plea that such outrages were committed not only without
his consent but without his suspicion. That he did not
expressly countenance such practices I concede. As to his
not suspecting that ignorant, untrained, ill-paid attendants
do continually outrage the finer feelings of patients, I im¬
peach the truth and the sincerity of such a denial. These
owners know what must be the natural consequences of their
niggardly policy.

Of their readiness to employ inferior attendants, I shall

312

A MIND THAT FOUND ITSELF

offer a striking illustration. The attendant who acted as
my protector at this sanatorium has given me an affidavit
embodying certain facts which, of course, I could not have
known at the time of their occurrence. The gist of this
sworn statement is as follows: One day a man — seemingly
a tramp — approached the main building at the sanatorium
and inquired for the owner. He soon found him, talked
with him a few minutes, and an hour or so later he was sit¬
ting at the bedside of an old and infirm man. This aged
patient had recently been committed to the institution by
relatives who had labored under the common delusion that
the payment of a considerable sum of money each week
would insure kindly treatment. When this tramp-attend¬
ant first appeared, all his visible worldly possessions were
contained in a small bundle which he carried under his arm.
So filthy were his person and his clothes that he received a
compulsory bath and another suit before being assigned
to duty. He then began to earn his four dollars and fifty
cents a week by sitting several hours a day in the room with
the aged man, sick unto death. My informant soon en¬
gaged him in conversation. What facts did he elicit ? First,
that the uncouth stranger never before had worked as an
attendant, nor had he ever so much as crossed the threshold
of a hospital. His last job had been as a member of a
section-gang on a railroad. From the roadbed of a railway
to the bedside of a man about to die was indeed a change
which might have taxed the adaptability of a more versatile
being. But as coarse as he was, this unkempt novice did
not abuse his charge, — except in so far as his inability to
interpret or anticipate the wants of the patient contrib¬
uted to that afflicted one’s distress. My own attend¬
ant, realizing that the patient in question was suffering most
of all for the want of those innumerable attentions which a

A MIND THAT FOUND ITSELF

3*3

trained nurse cannot fail to bestow, spent a part of his time
in this unhappy room, which was but across the hall from
my own. The end soon came. My attendant, whose ex¬
perience had been a wide one, detected the unmistakable
signs of impending death. He forthwith informed the
owner of the sanatorium that Mr. - was in a dying con¬

dition, and urged him (a doctor) to repair at once to the bed¬
side of the patient. The doctor refused to comply with the
request on the plea that he was, at the time, “too busy.”
When at last he did visit the room the patient was dead.
Then came the supervisor who took charge of the body.
As it was being carried from the room this “handyman” of
the owner’s said: “There goes the best paying patient the
institution had; the doctor” (meaning the owner) “was
getting eighty-five dollars a week out of him.” Of this
sum not more than twenty dollars at most could be con¬
sidered as “cost of maintenance.” The remaining sixty-five
dollars went into the pocket of the owner. Had the man
lived for one year the owner might have pocketed as a profit
(so far as this one case was concerned) the neat but wicked
sum of thirty-three hundred and eighty dollars. And what
would the patient have received ? The same privilege of
living in neglect and dying neglected.

To this day the relatives of the victim of this outrageous
neglect do not know of the injustice that was done them.
They believed that eighty-five dollars a week would in¬
sure the best of attention, — and so it would have done
had the trusted owner been deserving of the confidence
placed in him.1 From a reliable source I learn that the

1 Other instances of abuses existing in private hospitals for the in¬
sane will be found in Appendix IV, where a brief report appears, written
by M. Allen Starr, M.D., Professor of Nervous and Mental Diseases at
Columbia University.

3J4

A MIND THAT FOUND ITSELF

owner of the run-for-gain sanatorium discussed, brags that
his profit during a recent year amounted to $98,000. My
informant, a man conversant with the question at issue,
figures that a profit of six dollars a week from each pa¬
tient would have enabled this acquisitive owner to make
the $98,000 he professes to have made. But let us cut
the reported brag in two, just to be on the safe side.
Does any one believe that an inefficient owner of a sana¬
torium deserves to receive a yearly profit equal to the
salary of the President of the United States?

As to my own experience at this institution: during the first
weeks of it, my relatives were obliged to pay forty dollars a
week for my care. Under the circumstances it was not an un¬
reasonable figure — for, both by day and night, I required
an attendant; nor do I even affirm that the eighty-five
dollars a week, wrung from the rich man, was in itself
exorbitant. But is it right for the owner of a sanatorium
to demand and accept either forty or eighty-five dollars a
week, and then permit the helpless patient to be subjected
to indignities and neglect ? I know of a sanatorium where
the owner refuses to take any patient who cannot afford to
pay one hundred dollars a week. Pie caters to the wealthy,
and secures a sufficient number of patients to fill his hospital.
I respect that man. Pie deserves success, for he gives each
patient better care than he could possibly get in the most
self-sacrificing household. To expect him to reduce his
rates would be as unreasonable as to expect the owner of
real estate, simply because a church or hospital is to be
erected thereon, to sell it below the market price. The law
of supply and demand (together with a culpable lack of
State supervision) regulates the rates now charged by owners
of sanatoriums. Therefore the lowering of rates to a fair
figure can be brought about only when Psychopathic Hos-

A MIND THAT FOUND ITSELF

3TS

pitals and co-operative, or endowed, sanatoriums shall
have entered the field of competition. That such institu¬
tions will reduce the prevailing exorbitant charges, and
force the existing type of owner to treat his patients and
their relatives fairly, is at least indicated, if not proved, by
the fact that the Psychopathic Hospital at Munich, Ger¬
many, — the finest of its kind in the world — charges for
the most scientific treatment known, not more than $16.66
a week, and as low as $9.52; with a minimum of $4.97 per
week for patients unable to pay more. And as stated in
the Consular Report (Appendix II) “the treatment and
medical services are precisely the same to all, according to
condition and necessities.”

Not so, however, in a majority of private institutions.
The quality of the food, for instance, is likely to vary with
the fee paid. The poorer patients are, in a way, the buz¬
zards of the flock. The coarsest cuts are their accustomed
portion. To this the attendants themselves can testify,
for they are often forced to eat veritable husks — the crumbs
which fall from the owner’s table. In my opinion the
food served at the State Hospital was far better than that
served to many patients at this run-for-profit sanatorium:
and the food served at the large private hospital, conducted
not for personal profit, was, on the whole, as good as any
man might need or desire.

This comparison is illuminating. The owner of a pri¬
vate sanatorium is but human, and it is extremely difficult
for him to see any advantage in supplying food of quality
or variety, when, by so doing, his profit will be decreased by
thousands of dollars during a single year. The manage¬
ment of an incorporated and endowed institution, whose
only possible profit is to be found in their agreed salaries,
would not be likely to impose in this way upon their insane

3l6

A MIND THAT FOUND ITSELF

charges and patrons. No corrupting desire for gain would
influence them. It is highly desirable, therefore, that all
private hospitals for the insane should at once be brought
under rigorous State supervision, requiring that such insti¬
tutions be duly incorporated under laws which will protect
patients against abuse and patrons against extortion, — at
the same time permitting a trustworthy owner to make a
fair profit on his investment. Or, better still — and even¬
tually I hope to behold it — let there be no hospitals at all
run for private gain. I do not advocate a hasty change.
It will be years before there are in operation a sufficient
number of Psychopathic Hospitals, “mental wards” in
General Hospitals, and co-operative sanatoriums to render
useless the existing type of run-for-gain institutions. In the
meantime Public Opinion, through proper channels, should
so far as possible force owners of private hospitals to re¬
duce their charges to a fair figure and, at the same time,
treat all patients with consideration and honesty.

The field is before us! The disgrace of the facts (of
which I have related but a few) still cries to Heaven.
Though the days of dungeons, manacles, shackles, ropes,
straps, and chains have, in the main, passed, it should
yet be borne in mind that our great hospitals, with their
beautiful grounds, are too often but cloaks wherewith
a well-intentioned but blind civilization still covers a
hideous nakedness. This cruel and deceptive cloak must
be torn off. Let these mysteries be converted into open
Truth and Fairness. That the public has long been de¬
ceived by appearances is not surprising. For, even I, in
walking casually through the wards of such a hospital, find
it well-nigh impossible to realize that many of the inmates
are subjected to even mild abuse. Even I, who have suf¬
fered the most exquisite torture from “muffs” and strait-
jackets (camisoles), have, in my several tours of inspection at
State Hospitals, looked upon a patient so bound with a feel¬
ing rather akin to curiosity than sympathy. So innocent do
these instruments of restraint appear when one views a
victim for the few moments it takes to pass him by, it is
little wonder that a glib-tongued apologist of “Restraint”
may easily convince one that the bound patient is, in
fact, better so. Nevertheless, he is not better so. The few
seconds that the observer beholds him are but an infinitesi¬
mal fraction of the long hours, days or weeks, that he must
endure the embrace of what soon becomes an engine of
torture. There is but one remedy for the evils attending

317

3lS A MIND THAT FOUND ITSELF

the mechanical restraint of the insane. At once and for¬
ever abandon the vicious and crude principle which makes
its use possible.

The question is: will the reader help to bring about im¬
proved conditions? If so, let him take his stand as an
advocate of Non-Restraint. So will he befriend those un¬
fortunates whose one great need may best be epitomized in
these words — the words of a man who for a score of years
worked among the insane in the capacity of assistant
physician, and later as superintendent of a state hospital.
His simple though vital remark to me was: “After all,
what the insane most need is a friend!”

These words, so spoken, came with a certain startling
freshness. And yet it was the sublime and healing power
of this same love which received its most signal demonstra¬
tion two thousand years ago at the hands of one who restored
to reason and his home that man of Scripture “who had his
dwelling among the tombs; and no man could bind him, no,
not with chains: Because that he had been often bound with
fetters and chains, and the chains had been plucked asunder
by him, and the fetters broken in pieces: neither could any
man tame him. And always, night and day, he was in
the mountains, and in the tombs, crying, and cutting him¬
self with stones. But when he saw Jesus afar off, he ran
and worshipped him, And cried with a loud voice, and
said, What have I to do with thee, Jesus, thou Son of the
Most High God? I adjure thee by God, that thou torment
me not.”

For twenty centuries the cry of the insane has been and
to-day is: “Torment me not! Torment me not!”

PART V

XL

My plea has been presented; but the story of the organ¬
izing of The National Committee for Mental Hygiene, in
furtherance of which project this book was published,
remains to be told. Why I tell it in an intimate way in this
revised edition of “A Mind That Found Itself,” is made
plain in the following letter from Dr. Stephen P. Duggan,
Professor of Education at the College of the City of New
York, who, as a member of the Executive Committee of
The National Committee for Mental Hygiene, speaks from
personal knowledge of the work :

New York City

Du. Mr. Beers: 7’ m6'

When you again publish a revised edition of your book, I
hope you will substitute, for the impersonal account presented
in Part V of recent editions, an autobiographical account of the
origin of The National Committee for Mental Hygiene. As
thejrork you did in connection with it is comparable to that
done for the insane during the last century by Dorothea DLx
and by Pinel in the eighteenth century, you owe it to your
readers to tell the story of the organizing of the first “societies
for mental hygiene” and of what they have done to focus the
attention of the public on the great problem of mental health.
I his I say advisedly for even I, a member of the Executive
Committee of the National Committee for some time past, did
not learn in detail, until recently, of your unique services during
the formative period of work.

319

320 A MIND THAT FOUND ITSELF

I know of no better way for you to conclude your story than
by quoting some of the many letters sent to you by those who
gave moral or financial support, or both, while you were organiz¬
ing the National Committee and stimulating interest in the
mental hygiene movement in general. These letters, which
you kindly let me read when I asked for the intimate story of
your pioneer days in mental hygiene work, not only held my
attention but left me with the feeling that everything I could
do to further the work should be done. It seems to me that
others privileged to read the opinions mentioned will be similarly
affected, with benefit to the cause.

Permit me to say in closing: Do not hesitate to publish the
letters in which complimentary references to yourself appear.
One cannot speak well of the work without thinking well of
the man who had the moral courage, persistency and ability
to make this important work possible.

Sincerely yours,

{Signed) Stephen P. Duggan.

The first step toward organizing the National Com¬
mittee for Mental Hygiene involved the securing of a
publisher for my book — no easy task for an unknown
writer, with an unusual subject. In this, however, Professor
William James helped by giving me a letter of introduction
to Longmans, Green & Company, who soon accepted my
manuscript. Without doubt the opinion of Mr. James was
a determining factor in its acceptance, as was the opinion
of Dr. Thomas R. Lounsbury, late Professor of English
literature in the Sheffield Scientific School at Yale Univer¬
sity, who, under date of March 24, 1907, wrote as follows:

I have gone over with great care that portion of your manu¬
script which you let me have — amounting, as I understand,
to about one half of the whole — and can testify that to me at
least the interest of the narrative far exceeds that of any novel

A MIND THAT FOUND ITSELF

321

which I have read in a long, long time. It strikes me indeed
as being something besides a truthful, human document; it is
a well-told document, which, one must say regretfully, truthful
documents are too often unapt to be. I do not believe, in fact,
that any intelligent person, whose attention has been called to
the subject, will lay down the work willingly, after he is once well
started in its perusal. To its interest I can testify for myself;
to its value as an inside account of an insane person’s psychol¬
ogy, after the opinion given by such an authority as Professor
James, nothing further can properly be said by any one.”

In securing the endorsement of persons who could speak
with authority, it was not only desirable to be vouched for
by a psychologist and by a writer of commanding position
in their respective fields, but most important of all, per¬
haps, that I should secure the approval of some physician
who had made a special study of mental diseases and had
first-hand knowledge of the problem of state-care of the
insane. Dr. Stewart Paton, a psychiatrist of note, though
not one who had served in the State hospital field, wrote
to me as follows, under date of May 30, 1907:

It is needless to say that you have my best wishes for
success in your undertaking. After reading the manuscript
you so kindly sent me, I feel sure intelligent people will listen
to your appeal and take an active interest in this work.
Surely you will be a public benefactor if you succeed in
realizing your ideals.”

Through the courtesy of Dr. Paton, who advised me that
Dr. Adolf Meyer, then Director of the Psychiatric Institute
of the New York State Hospitals at Ward’s Island,, New
York City, now Director of the Phipps Psychiatric Clinic at
Johns Hopkins Hospital, Baltimore, was the one man of all
others in his special field whose support should, if possible,
be secured, I was able to submit to Dr. Meyer the page

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proof of my book and outline my plans. This proved to be
a most fortunate occurrence as Dr. Meyer for a long time
had wished that some organized movement for better care
and treatment for the insane and for the prevention of
mental disorders might be inaugurated in this country.
He and I, therefore, at once began to collaborate.

It is interesting to note that when Dr. Meyer and I first
met in September 1907, the term " mental hygiene” had
never been used in connection with organized work for
mental health. Indeed, at our first meeting, Dr. Meyer
was at a loss to find the word or words that would express
not only the idea of amelioration of conditions among the
insane but also the idea of prevention of mental disorders.
A few days later, he informed me that "mental hygiene”
was the term needed for the purpose in view. This was
a happy choice. Not only did "mental hygiene” describe
the work as originally planned; it will continue to describe
it accurately regardless of its growth.

If I took the initiative in the founding of the National
Committee for Mental Hygiene, it was Dr. Meyer who,
because of his profound knowledge of the scientific, medical
and social problems involved, helped more than anyone else
to place its work on a sound basis. After my manuscript
and plans had been carefully examined by Dr. Meyer, he
sent me, under date of October 27, 1907, the following
letter, which proved of great value and helped secure the
co-operation of other psychiatrists and hospital officials
whose support was so essential to success:

To Whom It May Concern:

Since about a month ago, when Mr. C. W. Beers was intro¬
duced to me by Dr. Stewart Baton, I have had an unusual
experience in finding in him a man not only without a chip on

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323

his shoulder, but one with a sound and worthy conviction that
something must be done to meet one of the most difficult but
also lamentably neglected problems of sociological improve¬
ment. Unlike so many ex-patients to whose efforts we owe in
many ways the preposterous forms of legislation concerning the
insane and many prejudices about the hospitals, Mr. Beers has
given us a description of his personal experiences, has pointed
out his own impressions and suggestions for remedy and has
asked for advice with an open mind, with such willingness to
accept and use new conceptions of matters not broadly enough
viewed by him before, that it looks as if we had at last what
we need: a man for a cause. The difficulties to be met are such
as to be unsurmountable to any one who has not the personal
experience and instinctive foundation for what must equal a
religious vow of devotion of his life to a task before which
others have become opportunistic, if not indifferent.

Mr. Beers plans to subordinate his activity to a body of men
and women who shall be chosen by a temporary Board of
Trustees of the cause. It will be a difficult task to find the not
very common level-headed and well-informed persons in various
parts of the country capable of organizing the public conscience
of the people. Neglected by physicians and dreaded by the
fiscal authorities, the facts are not available to-day, except in
fragments, mixed up with innumerable extraneous considera¬
tions; the hospitals are closed corporations, the press injudicious
in inquiry and reform, and those capable of judgment unable
to get the facts. The crying needs persist in the meantime.
Instead of a land fund (the 12,225,000 acres bill and ideal of
Dorothea Dix) we must have a permanent survey of the facts
and efficient handling of what is not prevented. The experience
with what remains as inevitable experiments of nature as well
as with people who should know better, must be put into prac¬
tical form for communication and teaching, and brought home
where it will tell; in opportunities of work and education for
physicians, and co-operation between our educational forces
and those who labor for physical hygiene and prophylaxis.

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A MIND THAT FOUND ITSELF

Most of us are already under too many definite obligations
to meet the call for devoted work for the maintenance of an
organization as well as can Mr. Beers. In my judgment, he
deserves the assistance which will make it possible for others
to join in the work which will be one of the greatest achieve¬
ments of this country and of this century — less sensational
than the breaking of chains but more far-reaching and also
more exacting in labor.

A Society for Mental Hygiene with a capable and devoted
and judicious agent of organization will put an end to the w’ork
of makeshift and short-sighted opportunism, and initiate work
of prevention and of helping the existing hospitals to attain
what they should attain, and further of adding those links
which are needed to put an end to conditions almost unfit for
publication. What officialism will never do alone must be
helped along by an organized body of persons who have set
their hearts on serious devotion to the cause.

If Mr. Beers gets the means to pursue his aim he will secure
the body which will guarantee proper judgment in a cause
which has been a mere foster-child in the field of charitable
donations merely because it seemed too difficult. Here is a
man who is not afraid of the task. May he get the help to
enable him to surround himself with the best wisdom of our
Nation!”

Though the securing of moral support for the projected
National Committee was of prime importance, I appre¬
ciated that financial support would be equally necessary
and so began to open ways to secure it. Mr. Anson
Phelps Stokes, Secretary of Yale University, who was one
of my most active and helpful advisers during the diffi¬
cult, first years of work, interested many people of
influence in my book and project. During the summer
of 1907, he placed my manuscript before Mr. Frederick
T. Gates, who, before the Rockefeller Foundation was

A MIND THAT FOUND ITSELF

325

established, had almost exclusive charge of Mr. Rocke¬
feller’s philanthropies. Under date of October 30, 1907,
Mr. Gates wrote to me as follows:

I am sending you herewith by express, at the request of Mr.
Anson Phelps Stokes, the manuscript copy of your forthcoming
work, which I have read with the deepest interest. I am very
glad to learn from your recent letter to Mr. Stokes that you
will publish soon. I have no doubt that your work will become
a classic in its line, and if properly launched it will have a
great and immediate popular success and produce a profound
impression throughout the country.”

_ Though the sending of my book to Mr. Gates at this
time, and to others connected with Mr. Rockefeller’s
philanthropies, had no immediate effect on the situation,
the fact remains that the Rockefeller Foundation, founded
subsequently, contributed liberally to The National
Committee for Mental Hygiene when its plans for surveys
and special studies had been definitely formulated.

As the work in view was to be, in part, an educational
campaign, I decided to secure the support of some of the
high officials of various universities. One of the first of
these to accept membership in the National Committee
was Professor Russell H. Chittenden, Director of the
Sheffield Scientific School of Yale University, who wrote
as follows, under date of December 4, 1907:

I am in receipt of your letter of December 4th, asking me to
serve as one of the Honorary Trustees of the Society for Mental
Hygiene, about to be established. Having read the manu¬
script of your forthcoming book, I have been much impressed
Dy the story of y°ur personal experiences, and I believe that
much good can be accomplished for humanity by such a society
as is contemplated. My knowledge of the underlying facts of
your story, as related to me from time to time, at the date of

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A MIND THAT FOUND ITSELF

their occurrence, by your brother, has given to me a realization
of the truthfulness of the account of your personal experiences,
and as a result I have been the more strongly impressed with the
necessity for some movement tending to betterment of the
conditions under which the insane are forced to live. A fuller
understanding of methods of treatment such as can be fostered
by a Society of the kind contemplated will do much toward
improving the conditions of this unfortunate class. I trust
that you will succeed in the efforts you are making.”

Miss Julia C. Lathrop, then of Hull House, Chicago,
now Chief of the Children’s Bureau at Washington,
wrote as follows, under date of January 2, 1908:

I have devoted my spare time yesterday and today to read¬
ing the proof of your book. The autobiography is a most
touching and appealing document. I earnestly hope that its
admirable literary form may secure for it the wide reading so
desirable for your purpose.

I have felt for some time that a national society for the study
of insanity and its treatment, from the social as well as the
merely medical standpoint, should be formed. I am glad to
follow in the line you have indicated and to have my name
appear as one of the honorary trustees. I have talked with
Miss Addams and she has agreed to the use of her name and
will so inform you soon by letter.

I see many indications of a strong revival of interest in the
care of the insane and I cannot but believe that we shall within
a few years see them treated generally as sick persons.”

Dr. August Hoch, one of the leaders in psychiatry in
this country, at the time Clinical Director at Bloomingdale
Hospital but now Director of the Psychiatric Institute of
the New York State Hospitals, Ward’s Island, New York,
wrote as follows, under date of January 4, 1908:

Your letter reached me yesterday, and your book this morn¬
ing. I have just spent several hours reading the latter, not

A MIND THAT FOUND ITSELF

327

only the parts to which you called my attention especially, but
others as well. What I have read is extremely interesting, not
only psychologically, but in its broad bearing as well, which
you so fully appreciate. There is no doubt that a society such
as you propose could do much to stimulate progress in the
care and treatment of the insane, as well as in the study and
teaching of psychiatry in this country. In all these branches
much is yet to be done. The time for your undertaking is
ripe.

I highly appreciate your kindness in asking me to be a trustee
of the society and I gladly accept your offer, assuring you at
the same time that I shall cheerfully do whatever lies in my
power to assist in a cause in which I am naturally deeply
interested. I wish you success in your undertaking.”

A letter from Dr. William L. Russell, then Medical
Inspector of the New York State Hospital Commission,
now Medical Director of Bloomingdale Hospital, read
as follows, under date of January 16, 1908:

I am returning the proof sheets of your book under separate
cover by registered mail. I need scarcely tell you that I have
been intensely interested. I have read every word, and much
I would gladly read again as, indeed, I certainly shall as soon
as the work is published. You are quite right in thinking that
an aroused public sentiment is necessary to effect any great
improvements in the care of the insane. Without this, even
earnest and enlightened workers cannot either obtain sufficient
funds or eliminate selfishness and inefficiency in applying them.

I am inclined to think that conditions in this State are rather
better than in most others. We see, however, many defects,
and I most sincerely trust that your efforts will be rewarded
with success.”

Early in January, 1908, and acting largely upon the
advice of Mr. George McAneny of New York, who had
had wide experience in social work, it was decided to

328

A MIND THAT FOUND ITSELF

call the society “The National Committee for Mental
Hygiene,” limit its membership and make it a “Com¬
mittee,” rather than an “Association” with general
membership. This was done as the task in hand was a
very special and, in many ways, delicate one. Further¬
more, it was believed that the National Committee could
not appeal for general members without interfering with
the rights of the State Societies for Mental Hygiene and,
perhaps, securing funds which more properly belonged
to them. Events have proved that this was a wise
policy to adopt.

Dr. Jacob Gould Schurman, President of Cornell Univer¬
sity, wrote as follows, under date of February 21, 1908:

I have now read all the pages which you set apart for my
consideration. Let me say that they have interested me
immensely. It is a most extraordinary thing to have a book
written under such circumstances. If there is anything like
it in the history of literature, I am not acquainted with it.
And then, apart from the circumstance that we have in this
volume an account of insanity by the sufferer himself, I have
been greatly impressed with the author’s lucidity of style, poise
of judgment, and variety of knowledge outside his own special
field, as well as the reformatory zeal with which he addresses
himself to the problem of the intelligent and humane treatment
of the insane.

I should predict for the book a great success, merely as a
piece of literature. I earnestly hope it will go a long way
towards accomplishing the reformatory object to which it is
dedicated. And if you think I can be of help in that direction
I shall certainly be very glad to accede to your request to serve
as an honorary member of the National Committee for Mental
Hygiene as outlined in your letter. I am leaving tomorrow for
a week’s absence filling engagements in the Northwest. My
first impulse was to take your book with me and read it on the

A MIND THAT FOUND ITSELF

3^9

train. But on looking again at your letter I find that you
wish it returned as soon as possible. Accordingly I am mailing
you the book under another cover today.

With congratulations on your remarkable achievement, and
with all good wishes for the success of the cause you have so
much at heart, a cause with which I have had a little experience
as Visitor of the New York State Charities Aid Association to
the State Hospital for the Insane at Willard, I remain, Very
sincerely yours.”

Dr. W. H. P. Faunce, President of Brown University,
under date of February 24, 1908, wrote as follows:

Surely no one can read your manuscript without sympathy
and without being fascinated by its clear presentation of a
remarkable experience. I shall be glad to serve as one of your
honorary trustees and hope that much good will come from the
organization of the National Commitee for Mental Hygiene.”

Having secured the support of more than thirty repre¬
sentative men and women who were willing to serve as
honorary trustees of the National Committee for Mental
Hygiene, I now felt secure in placing my book before the
public. It was published on March 16, 1908, and im¬
mediately attracted wide and favorable attention — if
the reviews which appeared in more than one hundred
newspapers and periodicals in this country and Great
Britain may be taken as a criterion.

When “A Mind That Found Itself” was published,
the projected National Committee for Mental Hygiene
could have been formally founded at once. This, how¬
ever, did not occur until February 19, 1909, as it was
thought best that a State Society should first be estab¬
lished by way of experiment on a smaller scale. I there¬
fore organized the Connecticut Society for Mental Hygiene,
which began its work on May 6, 1908. While serving as

33°

A MIND THAT FOUND ITSELF

its Executive Secretary and developing its work, I continued
to enlist support for the National Committee. With bound
copies of my book now available and with an impressive
collection of favorable opinions in my possession my task
became easier. That is, it was easy to secure moral sup¬
port. Securing funds for the work, however, was more
difficult, as this chapter will show.

That those who accepted membership in the National
Committee became more interested in its plans the more
they studied them, is indicated by President Schurman’s
second letter of March 27, 1908. To quote:

I want to thank you very cordially for your book. I have
now read it through. It is a wonderful volume — whether one
considers its contents or the circumstances of its origin — and
I find it intensely interesting. I found myself constantly ad¬
miring your literary gifts. And it is curious to reflect that
they might never have come to a birth but for your domicile
in a hospital for the insane. It is the last place in the world
one would have selected as a school of liberal culture, yet in
your case it meant a good deal more for your literary develop¬
ment than a college does for the generality of the students.

I need not say that the recital of the sufferings you endured
deeply stirred my sympathy and at the same time aroused my
indignation. It is clear there is need for reform. And I suppose
no other man is so competent to undertake it as yourself.

I take the liberty also of making a suggestion to yourself.
You must not expect too sudden or too great a reform. Even
good causes make their way slowly in this rough work-a-day
world. You conceived your vocation as a reformer while you
were a patient in the hospital. And as I read your book, I
sometimes thought you entertained loo extravagant hopes in
regard to actual achievement. And so I feel like saying to you
that you must not be disappointed if you find things moving
slowly and gradually.

A MIND THAT FOUND ITSELF

331

You will not infer from what I have said that my own in¬
terest has been lessened by reading your book. On the contrary,
it has been greatly increased, and I should be glad to aid so
good a cause in any way in my power.

With kindest regards and with congratulations on your
production of so wonderful a book.”

In acknowledging the receipt of a complimentary copy
of my book, sent apparently at the psychological moment,
Mr. Jacob A. Riis, under date of April 3, 1908, said:

A woman, to whom a year or two ago I gave a lift that helped
open the bars of the worse than prison in which she was con¬
fined without just cause, came into my office, the other day,
with tears in her eyes and asked me to read your book, which
she hailed as the promise of freedom for, she said, “countless
hundreds” of men and women as unfortunate as she was. And
now today I found it upon my desk. I shall read it — I know
already from the reviews what to expect — and I hope my
poor friend is right. Meanwhile let me thank you very heartily
for your gift. The world is so busy that it passes such suffering
by unheeding because it “has not time” to heed. If your
book shall make it stop and pause, you have certainly rendered
a service to your day that ought to be a monument indeed.
We will all help.”

On April 10, 1908, Mr. Riis wrote again, as follows:

I have nearly finished your book and I am quite ready to
help, for I see it is needed. My friend was right, and in losing
your reason you found, I hope, ours for us in this pitiful matter.”

Dr. M. Allen Starr, formerly Professor of Neurology at
Columbia University, wrote to me as follows, under date of
April 11, 1908:

I have read with much interest your book which you so
kindly sent me. It is a wonderful record, interesting from the

332

A MIND THAT FOUND ITSELF

psychological analysis of your mental condition, and most im¬
portant as a protest against the bad nursing and inefficient
medical direction prevalent in our asylums, especially the
private ones. I have had only too many instances in my
own experience which substantiate all the arraignment you
make.

You have my sincere sympathy for your sufferings — and if
any definite steps are taken in the line of reform in which I can
help, you will have my hearty support.”

In seeking advice as how best to organize the National
Committee for Mental Hygiene, I naturally consulted
those in charge of the work of similar organizations. Dr.
Livingston Farrand, then the Executive Secretary of The
National Association for the Study and Prevention of
Tuberculosis, now President of the University of Colorado,
wrote as follows, under date of April 25, 1908:

I read your book last night. The best proof of my interest
is that I finished it before going to bed. It is one of the most
striking and convincing documents that I have ever seen.

I have long felt that one of the most important phases of
the present great movement in the direction of preventive
medicine, and at the same time one of the most neglected, is
that of mental hygiene. There is no doubt at all that very
great good could be accomplished by an educational campaign
dealing with the causes, prevention and adequate treatment
of abnormal mental conditions. I do not believe that there
could be a better means of engaging public interest than by
making an attack upon the present shocking abuses in the
treatment of the insane the peg upon which to hang the broad
educational movement, which, after all, is the object of chief
importance. After thinking over your propositions with some
care I see no reason why a national movement such as that you
plan should not be entirely successful, and I am writing not
only to thank you for the stimulus which your book has given

A MIND THAT FOUND ITSELF

333

me personally but to assure you of hearty co-operation wherever
possible in assisting such a movement. You have my very
best wishes and renewed assurances of my co-operation.”

One who rendered great assistance on many occasions
was Dr. William H. Welch, the acknowledged leader of
the medical profession in this country. Under date of
May 24, 1908, Dr. Welch wrote as follows:

I am glad to see that your efforts are beginning to be fruitful
and that State and National Societies are to be formed to carry
on the work.

Your book, which you kindly sent me, I read with great
interest, and do not see how it can fail to be of great service.
So far as I have observed, its reception both in the medical
profession and by the general public has been sympathetic and
encouraging. My copy has been loaned to several friends upon
whom it has made a strong impression.

I hope that you will continue to lay special emphasis upon
the need of psychopathic hospitals and wards in connection
with general hospitals, and especially with the university
medical schools. The greatest need is for improved care and
treatment of early and curable cases of mental derangement
and for border-land cases which can be prevented from passing
into the insane state; also for better instruction of students
and physicians in psychiatry. These needs will be met by
psychiatric institutions in connection with general hospitals
and university clinics better than by the familiar type of
hospitals for the insane existing in this country.”

Letters to the author of a book, if sent at all, are, I
realize, likely to be complimentary ones. I, therefore, find
satisfaction in quoting an opinion, equally favorable,
that came to me indirectly. It was sent under date of
June 8, 1908, by Mr. Wickliffe Rose, now Director-General
of The International Health Board of The Rockefeller

334

A MIND THAT FOUND ITSELF

Foundation, to the Rev. G. S. Dickerman, D.D., of New
Haven, who later forwarded it to me. To quote:

I read Mr. Beers’s book with the most intense interest.
To me it is a remarkable work. It impresses me as a bit of
genuine literature, remarkably well written and revealing
what is to me a new field of human experience. It is convincing
to a degree and left me with the feeling that I should like to
do something to remedy the conditions which he so vividly
portrays.

I am handing the book to friends, and hope to keep it traveling
on its mission. I wish to thank you for calling my attention
to it.”

The progress made toward organizing the National
Committee caused me to feel that at least one of the objects
I had in view in publishing my story was being accom¬
plished. On July io, 1908, Dr. William H. Welch sent me
a letter telling me that my book had played a part in the
negotiations \yith Mr. Henry Phipps that led to the estab¬
lishing of a Psychiatric Clinic at the Johns Hopkins Hos¬
pital. Thus I had the satisfaction of knowing that another
of my objects, as presented in the prefatory chapter of my
book, was being achieved. Dr. Welch wrote as follows:

I appreciated very much your telegram conveying your
cordial congratulations upon Mr. Phipps’s gift to establish a
psychiatric clinic, and I should have acknowledged it long
ago, but many engagements and absence from home have
prevented.

I knew that none would rejoice more than you at the good
news, and you may look upon the benefaction as one of the
fruits of your efforts. Mr. Phipps became interested in the
subject as the result of some remarks which I made at the time
of a visit in May to see the workings of the dispensary for tuber¬
culous patients which he has established in connection with the

A MIND THAT FOUND ITSELF

335

Johns Hopkins Hospital. These remarks were incidental and
without thought of making an appeal to him. Shortly after
his return to New York I received a letter saying that he was
interested in what I had said about the need of improved care
of the insane and desired further information. I then wrote
him rather fully about the need of an institution such as those
known in Germany as psychiatric clinics, and it will interest
you to know that among other pamphlets, etc., I sent him my
copy of your book, in which I marked many passages. His
son, Mr. John S. Phipps, who was in his father’s councils in
this matter, also procured a copy of your book.

When I told Mr. Phipps later how pleased you would be with
his gift, especially as I could say that your book had influenced
him, he himself expressed his pleasure at this. I told the
reporters also about this feature, and mention of you and the
book was made in the Baltimore papers, although not with as
much detail as should have been the case, if they had reported
my remarks more fully and accurately.

I want you to know these facts, as they must be a great
encouragement and gratification to you. The Phipps Psy¬
chiatric Clinic will, I think, be in a measure a fulfillment of
your dreams.

Have you seen the editorial based on your book in the London
Lancet of June 27, 1908? It will interest you. It emphasizes
especially the contribution which the book makes to psy¬
chological analysis, but I am not convinced that the criticism
is just that you should have separated the descriptive part
from the suggestions for reform, for these are most impressive
when introduced in connection with the need for improvement.
At any rate the editorial is one of the best notices of the
book which I have seen and is written evidently by one who
knows.

I cut out the page to send to Mr. Phipps as there is a passage
emphasizing the need of taking the study and treatment of
insanity out of their present isolation and bringing them into
closer contact with general medicine.”

336

A MIND THAT FOUND ITSELF

Instead of presenting in detail the original “plan of
work” of The National Committee for Mental Hygiene, I
shall quote from an address delivered at Chautauqua in
its behalf on August n, 1909, by the late Dr. Henry B.
Favill, of Chicago, who served as President of the Commit¬
tee during its first years of existence:

And now the question would be very pertinent, For whom
am I speaking? Why am I here today addressing you?

Briefly it happens in this way. A man in Connecticut,
Clifford W. Beers by name, was for three years confined in
various hospitals for the insane, had various experiences, and
ultimately, in 1903, regained his mental health. He came
through that experience with an accurate memory and acute
perception of everything that happened to him, a clear recollec¬
tion of all the perverted mental processes that he went through,
a keen sense of the misinterpretation to which his mental
processes were exposed, a very temperate resentment at the
unnecessary hardships and brutalities which he experienced,
the outgrowth of a system and not of personal default, and all
this he imparted in one of the most remarkable books of the
age, “A Mind That Found Itself.”

With tremendous conviction and singleness of purpose he
has devoted himself to the amelioration of social conditions
as they bear upon the question of mental integrity. He has
formed a society in Connecticut which is doing effective work.
He conceived the idea of a National Committee which should
do a comprehensive work in this direction. He selected a
Board of Directors from all over the country. Incidentally,
I was made the President of the Committee. I am here speak¬
ing the first public word which has been uttered in its
behalf.

A proper question is, What is our programme? At the
moment it is rather indefinite, and yet in a general way I can
say to you what we propose to do.

In the first place we need money to carry on an effective

A MIND THAT FOUND ITSELF

337

work. We hope to get that from some source. As the next
step, which seems logically to be the last step, which we shall
probably pursue, we propose actively to take up what is known
as “after care of the insane.” That means the establishing of
relations between patients who are about to be discharged as
cured, or partially cured, and their outside work, establishing
a connection which will continue a wise supervision out into
their social relations. The value of this is two-fold.

In the first place, its tendency is to prevent relapse by fore¬
seeing conditions unfavorable to the individual and prevent
their harmful operation. In this way probably a very large
percentage of the relapses can be prevented.

But, more than this, and probably far more important than
this, will be the relationship which becomes thereby estab¬
lished with the family and group and entire social circle of the
individual.

In establishing a harmonious relation in this way there is
no doubt that a great deal of impending mental disaster can be
averted. It is one of the ways in which early contact with
mental disturbances can be secured.

Please to realize the difficulty in this point. Supposing,
without any entering wedge, we undertake to go to a family
which we know to be more or less vulnerable and say, “You
have a bad family make-up, your family history is bad, you are
all liable to go to pieces mentally, we want to fix it.” Imagine,
if you can, anything more impossible to accomplish than results
upon such a basis.

On the other hand, if you can go into that situation naturally,
carefully and with a sympathetic connection already established
through an actual patient, there is practically no limit to the
access which can be secured. Whatever results are possible
from such early access can be achieved. Those are the merits
of “after care.”

Next, our programme is education, spreading broadcast, as we
may, correct ideas about insanity, mental balance, mental hy¬
giene, right living. A sample of this effort is my talk today.

33§

A MIND THAT FOUND ITSELF

And next, we shall attempt to effect legislation, to so alter
the laws and the procedure as to fit in with this fundamental
conception of mental unsoundness.

As a preliminary to that legislation, we must have popular
opinion. Legislation cannot go much beyond public opinion,
and it is our desire, and it will be our effort, to create public
opinion as fast and as widely as we may.

And, now, the question is, What do we want from you? The
answer is simple, — merely a hearing, merely a fair judgment,
as to the soundness of what we set forth, merely a sense of its
importance, and growing out of that a conviction as to your
relation to it.

We want a hearing and we feel confident that as a result of
a hearing we shall found an individual conviction on the part
of practically every one as to his obligation to help where he can.

I do not hesitate to say that of all the great public move¬
ments that are going on for the correction, the amelioration of
social conditions, there is none more important nor more de¬
serving of your earnest attention.”

As Mr. Phipps had shown so convincingly that he was
interested in improving the methods of treating the insane,
he was invited to become a member of the National Com¬
mittee for Mental Hygiene, which invitation he gladly
accepted. Here at last, thought I, is a man who, when
he understands the needs of the organization, will give
financial as well as moral support. Of moral support, the
National Committee had a great deal; of financial support
it had none at this time, except such as I had secured for
it, indirectly, in the form of loans made to me, personally.
Though I could ill afford to assume these obligations, the
fact that the National Committee was not yet organized
and had no funds for organizing expenses, made it necessary
for me to assume them. There was one loan, however,
made to me by Professor William James which he con-

A MIND THAT FOUND ITSELF

339

verted into a contribution toward the initial expenses of
organization. I had written Mr. James for advice regarding
the advisability of asking Mr. Phipps to “take over” the
debts I had incurred in organizing the National Committee
and to trust me or the organization to repay him later.
In giving my reasons for wishing to appeal to Mr. Phipps
for assistance, I had unwittingly appealed to Mr. James,
who, until now, had not been told of my debts. As I was
innocent of any intention of securing help from Mr.
James — one does not think of a university professor as
being in a position to play the role of philanthropist — I
found it possible to accept his gift, so generously offered
in the following letter:

_ _ London, August 16, 1008.

Dear Beers:

\ou seem to be doing splendidly, and I should be a caitif
not to chip in to the taxes which you have so nobly piled upon
your head. So I enclose to you an order on Lee Higginson &
Co. of Boston for $1000 to which extent I am only too willing
to bleed for the cause. So you need not think of paying me
till you become a millionaire yourself! I wish I could contribute
more to relieve you of your indebtedness. I can easily con¬
tribute this. In October I shall be home and glad to perform
whatever duties my place as committeeman of the Nat’l Society
may call for.”

In a subsequent letter, Mr. James said he thought it
proper for me to submit a statement of the organizing
expenses to Mr. Phipps, but I finally decided not to do
so, fearing I might in some way diminish the chance of
securing from him, later, substantial support for the active
work of the National Committee.

Though quoted out of its chronological order, I now
present another letter sent to me by Professor James, as
it was one of the opinions which served to sustain my

340

A MIND THAT FOUND ITSELF

courage while awaiting the day when the value of my ef¬
forts and work should be appreciated by the many, rather
than the few. To quote:

95 Irving Street, Cambridge,
January 17, igio.

Dear Beers:

Your exegesis of my farewell in my last note to you was
erroneous, but I am glad it occurred, because it brought me the
extreme gratification of your letter of yesterday.

You are the most responsive and recognizant of human
beings, my dear Beers, and it “sets me up immensely” to be
treated by a practical man on practical grounds as you treat
me. I inhabit such a realm of abstractions that I only get
credit for what I do in that spectral empire; but you are not
only a moral idealist and philanthropic enthusiast (and good
fellow!), but a tip-top man of business in addition; and to have
actually done anything that the like of you can regard as having
helped him is an unwonted ground with me for self-gratulation.
I think that your tenacity of purpose, foresight, tact, temper,
discretion and patience, are beyond all praise, and I esteem it an
honor to have been in any degree associated with you. Your
name will loom big hereafter, for your movement must prosper,
but mine will not survive unless some other kind of effort of
mine saves it.

I am exceedingly glad of what you say of the Connecticut
Society. May it prosper abundantly!

I thank you for your affectionate words which I return with
interest and remain, for I trust many years of this life,

Yours faithfully,

(Signed) Wm. James

Though I usually wrote directly to those whose interest
in the work I desired to enlist, on occasion I chose to
present my request indirectly. I used that method of
approach when I invited His Eminence, Cardinal Gibbons,
to serve as a member of the National Committee, for I

A MIND THAT FOUND ITSELF

34i

knew that Dr. William H. Welch, a personal acquaintance
of Cardinal Gibbons, was willing to support my request.
The following letters explain themselves:

807 St. Paul Street, Baltimore,

November 27, 1908.

To His Eminence, James, Cardinal Gibbons,

Dear Cardinal Gibbons:

I am writing this line in the hope that you may become
sufficiently interested in Mr. Clifford W. Beers and his remark¬
able book to be willing to encourage the national movement in
behalf of improved care and treatment of the insane, and of
better mental hygiene in general.

Mr. Beers’s book, “A Mind That Found Itself,” has made
a profound impression upon the medical profession as well as
upon the general public.

You will observe that Mr. Beers has secured the support of
eminent men in the movement which he has initiated. I feel
confident that you would do a great service toward better care
of the mentally afflicted, if you should be willing to lend your
name in support of the national society to effect this purpose.
With the highest respect, I am

Faithfully yours,

(, Signed ) William H. Welch

ARCHDIOCESE OF MARYLAND

Chancery Office
408 North Charles Street,

My dear Mr. Beers: ^ ov‘ 2$’ I9°9-

Some months ago your work, “A Mind That Found Itself,”
fell into my hands. I read it with profound interest. To me
it is a wonderful book. I scarcely remember ever having read
anything which stirred me so deeply, or left upon my memory
stronger or more vivid impressions. Its revelations of the
sufferings and the tortures which the mentally afflicted have

342

A MIND THAT FOUND ITSELF

been doomed to undergo must touch even the hardest nature,
and arouse compassion in every breast. Its purpose therefore
is a noble one, and I have not the slightest hesitation in accept¬
ing your invitation to enroll my name among the members of
the National Committee for Mental Hygiene, which is at
present being organized.

Indeed this movement to mitigate the sufferings and agonies
of this class of unfortunates commands my highest admiration
and merits my heartiest support.

With sentiments of great esteem, I am

Yours very sincerely,

{Signed) James, Card. Gibbons

As the pioneer State Society for Mental Hygiene, organ¬
ized by me in Connecticut in May, 1908, had proved
successful, plans for completing the organization of the
National Committee were now decided upon. The formal
founding occurred at a meeting held in New York City on
February 19, 1909. At this meeting, plans for work which
had been formulated with great care during the preceding
year and a half were adopted. To formulate these plans
had not been an easy task, as there was no society in
existence whose plan of work was sufficiently comprehen¬
sive to serve as a model for the work of the National
Committee, nor, indeed, of the pioneer State Society of
Connecticut, whose plans, by the way, were also made
by the group that organized the National Committee.
Work previously done, however, in behalf of the insane
in New York by the State Charities Aid Association had
made it easier to formulate part of the plans of the
National Committee, namely, those features relating to
state-care and to after-care of the insane, in both of which
fields the New York State Charities Aid Association had
done the pioneer work in this country.

A MIND THAT FOUND ITSELF

343

At the founding meeting of the National Committee in
1909, it was confidently believed that funds for the be¬
ginning of active work would soon be secured. A year
later, however, no gifts having been received, how to finance
the work became the chief topic of discussion at the second
annual meeting, held on April 9, 1910. The advice given
at that time by Dr. Favill, who was then president, proved
to be prophetic. To quote:

It seems to me very clear that the question of policy with
us at this moment is essentially a question of finance. If we
had money enough we would all be agreed that it was best to
organize efficiently with well paid officials and go into a com¬
prehensive campaign with which we could make good — educa¬
tionally, institutionally, and illustratively. If, on the other
hand, we have not money enough, the most that we could
accomplish would be a flash in the pan. Personally, I have a
very strong feeling that an appeal to any considerable number of
the public would be futile at this moment. Prof. Fisher has
stated part of it, namely, that the public does not understand
insanity. I am quite prepared from my personal experience to
state another part of it and that is, that the public does not
yield money to organizations except under a very definite and
protracted pressure and that only upon a presentation of things
so cogent as to be convincing in some degree or other — not
only of their importance but from personal relation — to the
individuals in question.

I am raising money or helping to raise money for many
organizations and I am thoroughly convinced of the difficulties
encountered in popular subscriptions. Aside from the question
of difficulty, however, I am as much convinced that the smaller
the source of our money at first the safer we are, just as I am
convinced that in the long run the wider our financial founda¬
tions, the safer we are. Any co-operation or support to this
movement at this time requires vision. If the individual
furnishing the money has not the vision, he must have faith in

344

A MIND THAT FOUND ITSELF

a few individuals who have vision and it has got to be the sort
of faith which will go on not only one or two but perhaps three
or four or five years before results can be achieved sufficient to
really be regarded as tangible and demonstrable results. The
public will not stand that sort of procrastination. The public
or any small portion of the public will not be able to have
loyalty and adherence to any proposition of this kind, to be
counted upon for support. I believe that we have got to find
a man who will come into this situation with a fund or a guar¬
antee, based upon a conviction, instilled into him by those who
have the power, as to the importance of the work and the
necessarily protracted character of the preliminary operations.
I think that our Finance Committee is the crux of the situation
and I predict, without any pessimism, that it will be found
that, unless a very limited focus of financial support can be
made, we will be a year hence in not a very different position
from what we are now. That is my feeling in the matter and,
consequently, I regard our deliberations today as being essen¬
tially the establishment of a financial policy which, if it can be
successful, will by that very fact establish to a large extent our
future organic policy.”

Dr. Favill was right. A year later, though The New
York Foundation had given three thousand dollars to the
National Committee, no large gift, insuring the continuance
of work on an active basis for a period of years, had been
secured. Failure to find the needed support was not
occasioned by any defect in the plan for work. The
trouble was that the “man of vision,” referred to by Dr.
Favill, had not been found. In November, 1911, however,
he revealed himself. Mr. Henry Phipps proved to be the
long-hoped-for patron to the cause. Though he offered
his gift while talking with Dr. William H. Welch, no one
had asked him to contribute. The gift was spontaneously
offered, as was characteristic of Mr. Phipps. His letter
of gift sent to Dr. Welch read as follows:

A MIND THAT FOUND ITSELF

345

New York City,
November 4, ign.

Dear Dr. Welch,

For some time past I have been thinking of what I could do
toward ameliorating the condition of the insane in public and
private institutions and I shall be very glad, as mentioned to
you this morning, if you will accept Fifty Thousand Dollars
($50,000) and appoint suitable parties to carry out such views
as you may have on the subject.

I will send you a check whenever it is required.

Sincerely yours,
(Signed) Henry Phipps

Though Mr. Phipps at this time was a member of The
National Committee for Mental Hygiene he, like most
other members, did not know much about its work — for
the simple reason it had done no active work. His desire,
as stated in his letter, was “to ameliorate conditions among
the insane in public and private institutions,” which was
one of the chief purposes of the National Committee for
Mental Hygiene. As might have been expected, Dr.
Welch recommended that the $50,000 be given to that
organization, which was soon done.

As this part of my book is autobiographical, I wonder
if I may with propriety tell of another gift made by Mr.
Phipps — this time to me in appreciation of my services
in organizing The National Committee for Mental Hygiene.

Shortly after the announcement of Mr. Phipps’s gift to
the National Committee, I received a note in which he
said: “I should like to take you motoring when you can
find time to call, giving me notice of a day or two. We
could have an interesting talk.”

A week later I spent an afternoon with Mr. Phipps.
While motoring he talked about my book and showed
lively appreciation of the service I had rendered in pub-

346 A MIND THAT FOUND ITSELF

lishing it and in organizing the National Committee for
Mental Hygiene. Evidently my story had given Mr.
Phipps the impression that one who had once suffered a
mental breakdown should not, after recovery, work too
hard and, above all, should not be subjected to worries.
I assured him that I had proved that I had a high degree
of resistance both to the strain of work and to such worries
as had been involved in carrying my work to a successful
issue. But Mr. Phipps seemed not to be convinced, for
he said, “How much would it take to keep you from
worrying?” This question was, indeed, a baffling one,
put to me — a man in debt on account of the work —
by a man of great wealth, famous for his generosity,
who had already shown interest in the work. I told
Mr. Phipps that as I was his guest it hardly seemed
proper for me to discuss my personal affairs and needs.
“I had you come to see me for the purpose of discussing
them,” said he. Then, continuing, he said, “Would five
thousand dollars be of use? I want you to have it as a
buttress — for a ‘rainy day.’” As the period from Jan¬
uary i, 1907, when I abandoned my business career and
an assured salary to give my whole time to the publishing
of my book and the organizing of the National Com¬
mittee, had, in a financial sense, been one continuous
“rainy day,” I at once accepted this golden bolt from
the blue that cleared my financial skies. The next day
I received the following note from Mr. Phipps:

1063 Fifth Avenue,
December 12, 1911.

Dear Mr. Beers:

It gives me much pleasure to ask you to accept the enclosed
check for five thousand dollars ($5,000), to be exclusively for

A MIND THAT FOUND ITSELF

347

your own use: nothing to do with the National Committee for
Mental Hygiene.

Trusting it may add to your pleasure,

Yours sincerely,

{Signed) Henry Phipps

This was, indeed, a timely gift, for I had expended more
than ten thousand dollars in publishing my book and or¬
ganizing the National Committee, eight thousand of which
represented money borrowed at banks, and from two in¬
dividuals who believed in my ultimate success. Through
a reimbursement previously voted me by the National
Committee on account of expenses incurred in its behalf,
both before and while serving as its Secretary pro tempore,
I had already paid three thousand dollars of my debts.
With Mr. Phipps’s unexpected gift I was now able to pay
all other debts. For the first time in nearly five years, I
enjoyed the privilege of knowing that I owed no one a
dollar on account of my work. I also had the satisfaction
of knowing that my judgment regarding the feasibility of
my project had at last been vindicated, for not only was
I out of debt but the National Committee had funds
sufficient for at least three years of active work.

In the first chapter of this book, I said that I builded
better than I knew when I organized The National Com¬
mittee for Mental Hygiene. That I had a right to say so
is proved by the following opinion of Dr. Walter E. Fer-
nald, Superintendent of The Massachusetts School for
Feeble-Minded at Waverley, who has long been recognized
as a leader in his special field. Under date of November
27, 1916, Dr. Fernald said:

The value of the service you have rendered to the insane
in organizing both national and state societies “ for mental

34§

A MIND THAT FOUND ITSELF

hygiene ” has, I know, been widely recognized. I wonder,
however, if it is generally appreciated that in creating these
new types of social agencies you rendered an equally valuable
service to that great group known .as the mentally defective.
Indeed, had you begun your work with the express purpose
of rendering help to the mentally defective, instead of to the
insane, you could not have planned an agency better fitted to
cope with the difficulties of the problem of mental deficiency
than is The National Committee for Mental Hygiene.

It has been my privilege to witness and, in various ways,
to participate in the growth of the now wide-spread movement
in behalf of the mentally defective. At first this was a slow
growth, but during the past ten years — and especially during
the past five — it has been one of the most striking social de¬
velopments of the day. Many individuals, groups and forces
have contributed to this fortunate result. The National Com¬
mittee for Mental Hygiene felt the force of this movement
within one year of the time it began its active work in 1912
and wisely began then to bring into its membership physicians
who had special knowledge of the problem of mental deficiency.
As in all new fields — when pioneer work is done by many
unrelated groups and by zealous individuals — there was great
danger that propaganda might out-run dependable data and
that unwise plans, policies and laws relating to state-care of
the mentally defective might be hastily adopted in many
States. This danger, however, has been averted, and I believe
that The National Committee for Mental Hygiene and its affil¬
iated State Societies are destined to continue to influence,
along wise and effective lines, the management of all phases
of the great problem of mental deficiency.”

Many fortunate occurrences have contributed to the
success of The National Committee for Mental Hygiene,
chief among them being the securing of Dr. Thomas W.
Salmon as its Medical Director when the active work was
begun in March, 1912. Having served as an officer of

A MIND THAT FOUND ITSELF

349

the United States Public Health Service for several years
and having gained special knowledge of the problem of
insanity as a member of the medical staff of a State Hospital
and later as Chairman of the Board of Alienists of the
New York State Hospital Commission, Dr. Sahnon was
able to place the work of the National Committee on an
effective basis within a short time. Fortunate, too, has
the National Committee been in having among its most
active members many of the leaders in psychiatry, general
medicine, education and social work in this country who
have given generously of their time in serving as members
of its inner committees.

From early in 1912 until the year 1915, the initial gift of
$50,000 made by Mr. Phipps financed the work of the Na¬
tional Committee. So convincing were the results of the first
three years of active work that it became possible to secure
other large gifts for its continuance. Mrs. Elizabeth Mil-
bank Anderson and Mrs. William K. Vanderbilt gave $50,000
each in the year 1915, in the form of pledges of $10,000 a
year for general expenses for the period ending in 1919;
and Mrs. E. H. Harriman and Mrs. Willard Straight have
made substantial contributions toward current expenses for
one of these years. In addition, liberal appropriations for
special studies and surveys have been granted to the Na¬
tional Committee by the Rockefeller Foundation. These
special grants already amount to more than $100,000 and
have enabled the National Committee to engage in funda¬
mentally important activities, such as surveys and special
studies, which could not otherwise have been undertaken.

Enough has been said to show that the success of the work
of the National Committee for Mental Hygiene is assured,
for support has now begun to come from several sources.
So great arc the needs, however, and so wide in scope is the

35o

A MIND THAT FOUND ITSELF

work that gifts for its development, and for endowment,
will continue to be needed. Though it is not necessary, I
am sure, to quote opinions showing that liberal support for
the work is deserved, I shall, nevertheless, quote two such
opinions in concluding this personal part of my narrative:
letters sent to me by Dr. Henry van Dyke and by Dr.
Charles W. Eliot. Dr. van Dyke wrote as follows:

The Hague, Netherlands
May 4, 1014.

Dear Mr. Beers:

I thank you for the new edition of your remarkable book,
“A Mind That Found Itself.” I have been reading it again
with a renewed sense of its interest and value.

The book is certainly of a most extraordinary quality. I
suppose that it stands quite alone in literature as a dear, vivid,
and sane narrative of the moving adventures of a human mind,
passing through the dark territory of insanity, and coming out
on the other side, not only with the power to tell of its wanderings
and sufferings, but also with the strong moral purpose to make
that experience a source of help to others and benefit to the
world.

In spite of the story of pain and grief and anguish which the
book contains, it is in its tone and spirit not pessimistic, but op¬
timistic, for it holds out a hope of victory to those who suffer,
and it points out a way in which those who sympathize can
really give assistance.

I have put your book in the hands of two men in important
official positions here. One of them sat up nearly all night to
read it, and said when he brought it back: “That is more
interesting than a novel.” The other man, whose own wife is
now in a sanitarium, wrote to me as follows: “I have not only
enjoyed reading it immensely, but I wish you to know that it
has given me added courage and hope.”

In sending you this message 1 desire to make it clear, not
only to you, but also to any friends of mine to whom you may

A MIND THAT FOUND ITSELF

351

show this letter, that I regard your book with very high esteem,
and that I think the cause which you represent in connec¬
tion with the National Committee for Mental Hygiene is of
immense importance and deserves generous help.

To alleviate the sorrows and sufferings of the insane is a
work that must appeal to every sympathetic heart. To prevent
the spread of mental disease and reduce the number of insane
in our country, is a work of the highest and most patriotic
service. You are at liberty to use this letter in any way that
you please, and I remain, with sincere and cordial regards,

Faithfully yours,

{Signed) Henry van Dyke.

Dr. Charles W. Eliot, President Emeritus of Harvard
University, who became a Vice-President of the National
Committee for Mental Hygiene before its active work
was begun, sent me the following letter after reading the
page proofs of the preceding part of this new chapter.
It is a cherished privilege to be able to conclude my
quotations from letters of eminent Americans by present¬
ing the opinion of one who has long been a conspicuous
leader in so many important fields of human endeavor.

Cambridge, Mass.,
17 January , 1017.

Dear Mr. Beers:

I am glad to hear that you are about to publish a revised
edition of “A Mind that Found Itself,” which will contain
an account of the organizing of the National Committee for
Mental Hygiene. Your part in creating that Committee was
so important that an account of it will be an entirely appro¬
priate addition to your book, which had a highly interesting
autobiographical character, and owed much of its immediate
influence to that quality.

I have just had the pleasure of reading the proofs of your
account of the creation of the National Committee for Mental

352

A MIND THAT FOUND ITSELF

Hygiene; and want to congratulate you at once on the friends
and supporters you have found in the prosecution of your
difficult enterprise, and to suggest that the work of the Com¬
mittee is sure to be permanent, and therefore should be
supported on a permanent endowment. The work of the
Committee now divides itself into original inquiries or surveys,
popular education concerning the care and treatment of the
insane and the preventable causes of mental disease and de¬
ficiency, and the organizing and advising of agencies (federal,
state and local) for promoting the objects for which the Com¬
mittee labors. All three of these objects have a permanent
character; although the function of inquiring and surveying may
later take the form of inspecting. A permanent work of this
sort should be supported by an adequate endowment.

Thus far in the life of the National Committee its resources
have been of a temporary nature, supplied chiefly by such very
unusual givers as Mr. Henry Phipps, Mrs. Elizabeth M. Ander¬
son, and Mrs. William K. Vanderbilt, and the Rockefeller
Foundation. I congratulate you that your Board of Directors
has already voted that an endowment fund be raised; and I
wish you prompt success in obtaining that endowment. \ ou
have already been so successful in enlisting both sympathy and
pecuniary support for your cause that I anticipate for you
success in this new undertaking.

Among your friends and supporters, the most interesting and
remarkable personage, to my thinking, was William James.
His letters to you about your work, and his gift of a thousand
dollars to your cause — for him a very large gift — must have
been very delightful to you, and helpful also. They moved me
very much as I read them last evening; and I hope that they
will move to aid you some among his numerous friends and
admirers who can afford the luxury and enjoy the privilege of
liberally endowing worthy and competent agencies for pro¬
moting human welfare.

Sincerely yours,

(Signed) Charles W. Eliot.

A MIND THAT FOUND ITSELF

353

While serving as Secretary of The National Committee
for Mental Hygiene, it has been my privilege to help
organize all but three of the sixteen State agencies for
mental hygiene now at work. Such societies, in the
order named, have been established in Connecticut, Illinois,
New York, Massachusetts, Maryland, Pennsylvania, North
Carolina, the District of Columbia, Alabama, Louisiana,
California, Rhode Island, Ohio, Tennessee, Missouri and
Indiana. The map on the following page, shows the growth
of the movement and indicates also the States in which
interest in organizing Societies is known to exist. At the
present rate of increase in their number, it will not be long
before each State has a Society for Mental Hygiene to
work in behalf of its insane, feeble-minded, epileptic,
inebriate and other mentally abnormal groups. The
general plan of work of these affiliated State Societies
will be presented after the active work of the National
Committee has been described. A directory of the state
societies will be found at the end of this chapter.

An interesting account of the aims of the National Com¬
mittee for Mental Hygiene is found in an address deliv¬
ered in September, 1912, by its President, Dr. Lewellys
F. Barker, Professor of Medicine at Johns Hopkins Uni¬
versity. To quote, in part:

It is right that, in an International Congress of Hygiene and
Demography, the subject of Mental Hygiene should have es¬
pecial representation. Though assigned, as a sub-section, to
the section on the Hygiene of Infancy and Childhood, thus
emphasizing its relations to inheritance on the one hand and to
the early environmental period of the individual on the other,
it might almost equally well, for other reasons, have been made
a sub-division in any one of the main groups of the Congress.
Indeed, so important is this sub-division for the welfare of in-

354

A MIND THAT FOUND ITSELF

A MIND THAT FOUND ITSELF

355

dividuals, of families, of communities, of nations, and of the
human race in general, and so wide spread its ramifications,
that committees on the organization of future Congresses might
well consider the establishment of an additional main section,
devoted entirely to Mental Hygiene.

By a campaign for mental hygiene is meant a continuous
effort directed toward conserving and improving the minds of
the people, in other words, a systematic attempt to secure
human brains, so naturally endowed and so nurtured, that
people will think better, feel better, and act better, than they
do now. Such a campaign was not to be expected before the
rise of modern medicine. For only with this rise have we come
to look upon states^ of mind as directly related to states of
brain, to view insanity as disordered brain-function, and to
recognize in imbecility, and in crime, the evidences of brain-
defect. The imbecile, the hysterical, the epileptic, the insane,
and the criminal, were formerly regarded sometimes as saints
or prophets, sometimes as wizards or witches, often as the victims
of demoniac possession, on the one hand to be revered or wor¬
shipped, or, on the other, to be burned or otherwise tortured.
Now, such unfortunates are looked upon as patients with dis¬
ordered or defective nervous systems, proper subjects of medical
care; some of them are curable; some are incurable, but still
educable to social usefulness; a part of them are socially so
worthless, harmful or dangerous as to make their exclusion from
general society necessary, or desirable. It is but a short step
from such a reformation of ideas, to the realization that less
marked deviations from normal thought, feeling, or behavior,
are also evidences either of brains defective from the start, or
made abnormal in function by bad surroundings or by bodily
disease. As examples of such marked abnormalities may be
mentioned those met with in children who are difficult to
educate, in young people arraigned in the Juvenile Courts,
in adults, who, inadequate to the strains of life, crowd our
hospitals or sanitoria on account of “nervous” or “mental”
breakdown, or who, owing to anomalies of character and con-

356

A MIND THAT FOUND ITSELF

duct, provide material for the news columns of the sensational
press.

Modern medicine has taught us to recognize that the condi¬
tions necessary for a good mind include, first, the inheritance of '
such germ-plasm from one’s progenitors as will yield a brain
capable of a high grade of development to individual and social
usefulness, and, secondly, the protection of that brain from
injury and the submission of it to influences favorable to the
development of its powers. Now if these doctrines of modern
medicine be true, the general problems of mental hygiene become
obvious; broadly conceived, they consist, first, in providing for
the birth of children endowed with good brains, denying, as far
as possible, the privilege of parenthood to the manifestly unfit
who are almost certain to transmit bad nervous systems to their
offspring — that is to say, the problem of eugenics; and second,
in supplying all individuals, from the moment of fusion of the
parental germ-cells onward, and whether ancestrally well-begun
or not, with the environment best suited for the welfare of their
mentality.

The natural sciences are built up by the gradual discovery of
causal relationships; and physicians and psychologists have,
since the time of Pinel, gone far in the establishment of the
laws underlying normal and abnormal phenomena of mind.
From the conviction that a proper application of the facts
already discovered can vastly improve the mental powers of
our people, decreasing to a large extent the prevalence of mental
defect and mental disease, has come the impulse to arouse public
opinion in favor of a definite plan for mental hygiene. This
impulse, thanks to the initiative of a layman, Clifford W.
Beers, (now Secretary of the National Committee), author of
“A Mind That Found Itself,” whose personal sufferings led
him on recovery to devote himself to the cause of mental
hygiene, and who enlisted the co-operation of a group of
representative men and women, has found expression in
the voluntary formation of a National Committee for Mental
Hygiene.

A MIND THAT FOUND ITSELF 357

In concluding his address, which dealt at length with
the plans of the organization, Dr. Barker said:

The task which the National Committee for Mental Hygiene
has set itself, is an enormous one. It hopes by investigation,
by education, and by organization steadily to improve the brain¬
power of the nation. It is striving to hasten the time when our
people will be so begot, and so reared, that their minds will
develop normally and harmoniously; when society will have
less need than now for sanitaria, asylums, and prisons; and
when all but an irreducible minority of those born to member¬
ship in the nation may think, feel, and act in a way that will
make them desirable citizens of that Better State which is our
goal.”

ACTIVE WORK

The following summary of the work, taken from reports
and statements issued since 1912 by the National Com¬
mittee for Mental Hygiene, the greater part of which were
written by its Medical Director, Dr. Thomas W. Salmon,
has been so arranged as to give the reader a clear idea of
what has been accomplished and what is planned. (A list
of the officers and members of the National Committee
will be found at the end of this chapter.)

The Field

While new methods of treatment and hopeful measures for
prevention have been eagerly welcomed and very effectively
applied in other fields of medicine, this has not been the case
in the care of the insane or in the prevention of mental diseases.
In this country at the present time the care of those ill with
mental diseases varies in the different States from the kind of
treatment which humanity requires for all other classes of the
sick to that which has come down to us from an age when the
insane were looked upon with superstitious fear and when cruelty
and neglect were their usual portion. It is apparent that only

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a nation-wide movement — carefully planned, scientifically
directed and adequately financed — can deal with the varied
and complex causes of these conditions or, indeed, even can
secure the accurate information necessary for effective work in
ameliorating them.

Importance of the Problem

Statistics alone cannot convey an adequate idea of the most
serious results of mental diseases — the personal suffering and
unhappiness, the social and family disasters and the business
troubles which they cause. It should be remembered that the
same factors which bring about the commitment of people to
institutions are responsible for much mental disease which is
never recognized and for loss of efficiency, failure to meet dif¬
ficult situations of life and conflicts with conventions and laws.
That these often depend upon mental disorders or mental de¬
fects is a fact not generally recognized. Accounts of murders,
suicides, marriage troubles and many kinds of misdemeanors
often have a very definite meaning for those who are familiar
with the abnormalities of conduct which result from mental
disease, while by others they are often ascribed to conditions
which are not in reality causes at all. The frequency of these
social disasters indicates the inadequacy of present methods of
dealing with the problem of mental diseases.

Care of the Insane

The care of the insane in different parts of the United States
shows the widest variation and it can be said that in most places
it has failed to keep pace with the great advances recently made
in the care of other classes of the sick. In many States insane
patients receive only custodial care and persons with curable
mental disease fail to recover on this account. In other States
many of the insane are in jails and prisons and, under such con¬
ditions, neglect and cruelty are common. All the insane are
cared for in State hospitals in only a very few States. In spite
of the fact that Dorothea Dix pointed out sixty years ago the

A MIND THAT FOUND ITSELF

359

inherent unfitness of almshouses as places for their care, insane
persons can be found in almshouses in most States today.
Nearly all hospitals for the insane are overcrowded. Political
appointments are made in some institutions and in certain States
entire changes in hospital organizations take place with changes
in State administrations. The internal arrangement of hospitals
and the classification of patients are often inadequate and they
are rarely standardized. Medical staffs are usually too small.
Nursing services are generally crude, attendants are underpaid
and insufficient in number, and facilities for the instruction of
nurses and attendants are often lacking. As a result, the use
of mechanical restraint is far too common. Appreciation of
the value of trained occupation instructors, social service workers
and recreation directors is spreading very slowly. In most
States little or no scientific study of patients is made and con¬
sequently individual treatment is impossible. There are no
standards in such States for proper case-records or opportuni¬
ties for medical research and the medical spirit is, therefore,
undeveloped.

In most localities patients are cared for in jails or lock-ups
during an early and very important period in their illness and
are transferred to hospitals by policemen or county officials.
Often women are taken to the hospitals by men. In some cases
persons with mental disease have to remain in jails for weeks
and even months before their cases can be taken up by the
courts and they can receive treatment in hospitals for the
insane. It can be said that practically every step in the history
of care for the insane is represented today somewhere in the
United States.

The legal requirements for commitment vary among the
States. In some States there is a jury system by which each
person must be tried in open court (permitting family secrets
to be revealed to idle lookers-on and become a source of gossip
in the community) and “convicted” of insanity before admis¬
sion to a hospital is possible. Under such conditions, patients
who would have been quite willing to go to a hospital for

360

A MIND THAT FOUND ITSELF

treatment if they had been permitted to do so, often feel that
they have been placed on trial for crime and develop de¬
lusions which render their mental disease more serious and
not infrequently injure their chances for recovery. In a few
States enlightened public opinion has made possible a form of
commitment which enables a person with mental disease to
be received for emergency treatment with nearly as little
formality as for other forms of illness, all his rights (including
the right to get well) being amply safeguarded. Provision
for voluntary commitment, for the liberal use of parole, and for
after-care are made use of in a few States, while they are not
employed in others and are quite unknown in some.

As a general rule, hospital treatment of mental diseases is
greatly deferred. In New York State nearly one-third of
the patients admitted give a history of having had their mental
disease for more than a year before securing treatment. This
is due chiefly to lack of facilities for the care of early cases of
mental diseases under conditions similar to those in general
hospitals, but it is due also to the inadequate training which
physicians receive in the study of mental disorders. With the
exception of a few medical schools, facilities for teaching psy¬
chiatry are meagre or do not exist. Post-graduate instruction
in psychiatry is practically unobtainable.

Care of the M entally Defective

Moved largely by realization of the importance of segrega¬
tion as a means of prevention but also by increasing familiarity
with the neglect which the feeble-minded receive in the com¬
munity and in unsuitable institutions, a movement exists in
many States to provide adequately for the mentally defective.
This movement is similar to that which led to general provision
for the insane between i860 and 1880, the period in which most
of the existing State Hospitals were built. Commissions have
been appointed to study the provisions required and the types
of patients who most need care in New York, New Jersey,
Michigan, Minnesota, Virginia, Delaware, Pennsylvania, Utah,

A MIND THAT FOUND ITSELF

36r

Kentucky, Florida, Illinois and Indiana. It is felt that this
Committee can give valuable aid to such Commissions by
informing them regarding what has already been ascertained.
We can also give advice regarding the scope and cost of similar
inquiries and regarding subjects to which special attention should
be given. We can help most by contributing to such Com¬
missions the services of scientific directors, as we have been able
to do in Kentucky, where an experienced physician, selected
and paid by our National Committee has recently begun work.
The experience gained in the long struggle to secure adequate
provision for the insane is certain to be of much value in this
work, for there are many points of similarity.

It has been found practicable to collect much information on
institutional provision for the mentally defective and on
the laws for their commitment and detention while obtaining
similar data for the insane. Each of the surveys made by our
Committee or conducted under our auspices has included the
mentally defective in its scope and a large part of the information
supplied in answer to inquiries from various parts of the country
relates to mental deficiency. Many plans for dealing with the
mentally defective in the community have been furnished and
this Committee is giving thoughtful study to the possibilities
of providing community supervision or guardianship, better
methods of dealing with defective delinquents and other
unstable and irresponsible individuals.

So rapid has been the increase in the demand for advice
and assistance regarding the problem of feeble-mindedness,
that the National Committee for Mental Hygiene has ap¬
pointed a special sub-committee, known as its Committee
on Mental Deficiency, to direct this part of its work. In a
recent report, its Chairman, Dr. Walter E. Fernald, Superin¬
tendent of the Massachusetts School for the Feeble-Minded,
stated that the National Committee had had requests for
information and advice upon the following topics:

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A MIND THAT FOUND ITSELF

1. The prevalence, importance, social effects and general
methods of dealing with mental deficiency.

2. The laws in different States providing for commitment,
supervision, and control.

3. Methods of identifying the mentally defective, the
practical utilization of mental tests and other diagnostic criteria,
the organization and operation of clinics for the diagnosis and
treatment of mental defect, school clinics.

4. Special classes in the public schools — how organized
and conducted, selection of pupils, courses of study, results of
training, after-care of former pupils.

5. Training of teachers for the special public school classes.

6. Detailed information concerning the organization, build¬
ing plans, construction, cost and general operation of public
institutions for the mentally defective.

7. Information concerning private institutions for the
mentally defective.

8. Laws and proposed laws providing for surgical sterilization
of mental defectives, — results of the application of such laws.

9. Extra-institutional care and supervision of the mentally
defective.

10. Clinical instruction in mental defect in medical schools.

11. Scientific research in mental defect — the correlation and
utilization of the results of past research in treatment and pre¬
vention; advice as to promising fields for future research.

12. Practical opportunities and possibilities for the dimi¬
nution and prevention of mental defect in families and in
communities.

13. Surveys to determine the prevalence of mental defi¬
ciency in the whole population of a State, in a community, or
in special groups of population, the conditions under which the
mentally defective are cared for, and the consequences of
their neglect.

As rapidly as funds permit, this work in behalf of the
mentally defective is being developed by the National Com-

A MIND THAT FOUND ITSELF

363

mittee for Mental Hygiene; and many of its affiliated State
Societies are focussing attention on this important phase of
mental hygiene work.

Prevention of Mental Disease

Humanitarian and economic reasons alike call for organized
efforts to control the spread of insanity. It is known that
there are certain essential causes of some mental diseases and that
some of these essential causes are within our control. More
people are known to die in New York State each year from
general paresis, a mental disease due to syphilis, than die from
typhoid fever. Syphilis causes other mental diseases and there
is probably no other single cause of insanity responsible for a
greater number of cases. In spite of this it is an amazing fact
that, even today, some of those most active in the field of ven¬
ereal prophylaxis are not aware that such a prevalent and uni¬
formly fatal disease as general paresis depends upon previous
infection with syphilis. About twenty per cent, of all first
admissions to hospitals for the insane are on account of the
alcoholic psychoses, forms of mental disease which depend up¬
on another essential cause of insanity. It is evident that these
are two controllable causes of mental disease.

In the varied conditions capable of producing mental disease
there are many other controllable causes, some of them deeply
imbedded in the social fabric and touching many phases of
personal life, education and general preventive medicine. This
fruitful and most important field for work in the prevention of
disease has practically been neglected thus far, very largely
on account of lack of popular information.

It is becoming more and more apparent that the most effec¬
tive work in the prevention of insanity, as well as in increasing
the efficiency and happiness of those who do not become insane,
must be done in early life. We know that much mental disease
and more disaster from imperfect adjustments to life of a little
different sort depend upon inadequate equipment to deal with

364

A MIND THAT FOUND ITSELF

difficult situations and upon attempts of people to live upon
levels of activity for which their mental equipment and training
have not fitted them. We know that in not a few cases these
inadequacies of equipment and this tendency on the part of
people to take up tasks for which they are manifestly unfitted
may be recognized at a very early period and there is reason to
believe that much could be done to remedy these conditions,
by recasting educational methods and providing for individual
needs. This, after all, is the true purpose of mental hygiene.
As issues become clearer and people turn to the consider¬
ation of these subjects it will fall to this Committee to give
constructive suggestions for including in the purposes of edu¬
cation the determination of the levels of capacity of different
individuals at which life may be conducted with greatest suc¬
cess. We may be able to show that any educational system
should include the recognition and possible correction in the
schools of tendencies which may wreck happiness and use¬
fulness in future years.

It is needless at this time to emphasize the importance of
heredity in the causation of insanity and mental deficiency.
Although the scientific study of heredity and the dissemination
of information regarding it is the special work of other agencies,
the influence of this Committee must be given to sound move¬
ments in eugenics and especially to the development of careful
and scientific methods of original inquiry.

Prevention of Mental Deficiency

General realization of the social, moral and economic import¬
ance of mental deficiency is essential if any of the means of pre¬
vention indicated at the present time are to be adopted, for the
measures which are needed will never be authorized without a
general public demand for them. It is within the province of
the National Committee for Mental Hygiene to emphasize these
matters in its exhibits and conferences, and to study carefully
existing legislation for the prevention of mental deficiency.

A MIND THAT FOUND ITSELF

365

The Work
General Plan

What has been presented is a very broad outline of the field
which the National Committee for Mental Hygiene has entered.
It is realized fully that in such an immense field efforts might
easily be so poorly directed as to accomplish few specific results.
With this in mind, a plan for systematic, constructive work, by
which different phases of the subject are to be dealt with one
at a time, has been prepared. Nearly three years were devoted
to careful study before this plan was adopted. The plan may
be summarized under three principal heads. The first is orig¬
inal inquiry regarding the status of the care of the insane and
of the mentally defective in this country — including not only
care of patients in special institutions but care in the communi¬
ties, in general hospitals and pending admission to hospitals;
regarding the opportunities for effective work in betterment
and prevention and, as resources permit, regarding some of
the more important controllable causes of mental disease. The
second is popular education, by which the importance of the
subject can be impressed upon the public, and facts already
known and those ascertained by special studies regarding con¬
ditions of care and treatment and the preventable causes of
mental diseases and mental deficiency can be made widely
known. The third is the organization of agencies to take part
in movements for betterment and prevention, including exist¬
ing agencies (Federal, State or local) and State and local
Societies for Mental Hygiene.

Original Inquiry

The following outline of the work proposed under this head¬
ing is from the plan of work adopted:

“A study will be made of the operation of the laws relating to insanity
and the insane; the official methods of dealing with mental cases; the
extent and character of institutional care; the extent and character of care

366

A MIND THAT FOUND ITSELF

outside of special institutions; the methods of discharge of patients and
their return to normal conditions, and such other particulars as it may
seem necessary to inquire into with a view of securing for the National
Committee full and accurate information concerning the situation in the
several States.”

Work in accordance with these plans has been carried on
steadily. It seemed essential at the outset to obtain a clear
idea of the provisions for the care and commitment of the
insane in the several States. The kind of care received by
the insane depends upon legislation more than does the care
of any other class of the sick. Indeed, good laws regarding
the insane are the essential foundation for good care, so we
secured the services of Mr. John Koren, who for several years
had been in charge of the statistical studies of the insane made
by the United States Census Bureau and who had already col¬
lected a great deal of material on this subject. Mr. Koren
prepared a summary of these laws, which was published by the
Committee in 1912. This proved of such value to us and
to others interested that a revised edition has been published.

Upon commencing to collect information regarding systems
of care and regarding individual institutions for the insane it
was found that no complete list of institutions existed. In¬
quiries were sent to Boards of Control and to institutions and a
complete list of these institutions was obtained. \\ ith this
list as a basis, detailed information is being secured and filed
in accordance with a system which is capable of indefinite
and continuous expansion. Clippings, reports and records of
personal inspections make these files of much value. Today,
such information is obtainable nowhere else.

Information regarding boards of control and administration,
the methods of their appointment, personnel, responsibility,
methods of work, and efficiency has also been collected and
filed and their annual reports are carefully analyzed. Infor¬
mation regarding movements for better care has been secured,
largely through clippings. It has been possible to keep
informed regarding legislation relating to appropriations, new

A MIND THAT FOUND ITSELF

367

institutions, changes of management, and investigations of
institutions as far as these matters get into the public prints.
Already thousands of such clippings have been collected and
filed. A chance newspaper item often furnishes an opening
for correspondence which may result in the acquisition of some
valuable information or which may give an opportunity to
participate in, or in some cases to direct, important movements
for betterment.

A card index, which now contains more than 14,000 titles
of articles in American, English, French and German medical
and popular literature regarding mental diseases and particularly
regarding mental hygiene and the care of the insane and mentally
defective, is being made. It is planned to publish bibliographies
containing selected lists of references to some of the aspects
of psychiatry and mental hygiene which are of general interest.

Besides information regarding these special topics, a great
deal of general statistical information relating to some of the
larger aspects of our problem (such as the prevalence of mental
disease, its relation to immigration, etc.) has been gathered and
is freely available to all who desire it.

In view of the vital importance of improving facilities for
early diagnosis and treatment of mental diseases, special efforts
have been made to obtain all the information available regard¬
ing psychiatric clinics and psychiatric wards and pavilions in
connection with general hospitals. Plans of nearly all such
institutions in the United States have been secured and redrawn
to a uniform scale for distribution to those interested. A pub¬
lication will be issued describing them and giving detailed
information as to their cost and cost of maintenance, the
organization of their medical and administrative services, the
purposes intended to be served and the actual results obtained.

Surveys

It was stated at the 7th Annual Meeting of the National
Committee, in 1914, that a plan had been prepared for a survey
of the care of the insane which, State by State, would finally

368

A MIND THAT FOUND ITSELF

include the entire country. Estimates of the length of time
required for the different States and the cost of services and of
traveling expenses were necessarily somewhat indefinite, as the
only experience we had upon which to base such estimates
was that gained in the surveys undertaken by this Committee
in Wisconsin and South Carolina and in that in Pennsylvania
which had been made by Dr. Haviland for the Pennsylvania
Public Charities Association. It was believed that not less
than $50,000 would be required to complete a nation-wide
survey of the kind which we had in mind. Although there
did not seem to be any immediate possibility of securing tiffs
sum we continued to make our plans and appropriated from
our resources for general expenses as much money as we could
spare for surveys.

In September, 1915, the Rockefeller Foundation appro¬
priated $22,800 for surveys in the sixteen States in which, for
one reason or another, it seemed to us work should be undertaken
first. This generous appropriation was most encouraging, for
we realized that our plans for definitely improving the treatment
of mental diseases in this country were about to bear fruit.

We commenced at once to arrange to make surveys in sixteen
States. There had always been some doubt in the minds of
many of those interested in the work of the National Com¬
mittee for Mental Hygiene whether such an unofficial organiz¬
ation would be permitted to examine such an almost exclusively
governmental function as the care of the insane. The first
surveys gave grounds for hoping that our fears had been ex¬
aggerated and it is very gratifying now to report that vol¬
untary invitations have been received from officials in nine
of these sixteen States, as well as from others which it had not
been intended to examine for some time to come. Perhaps
nothing can better illustrate this readiness on the part of
public officials to have institutions for the insane under their
supervision examined by this Committee than the following
letter from the President of the Board of Managers of the
State hospital in Georgia, known as the “State Sanitarium’ :

A MIND THAT FOUND ITSELF 369

Blackshear, Ga., January 28, 1916.
Dr. Thomas W. Salmon, Medical Director,

National Committee for Mental Hygiene,

50 Union Square, New York City.

My dear Sir:

I am advised it is the intention of your Committee to make a survey
of every State in the Union and that you have just finished with
Tennessee. If my information is correct, Georgia is doubtless on your
list for such a survey in the near future. The only institution owned by
the State for the treatment and care of the insane is the Georgia State
Sanitarium, located at Milledgeville, Georgia. Our Board of Trustees has
under consideration the question of employing competent experts to make
a survey of the Sanitarium from both medical and economic standpoints
and I will be very glad if you will advise me if such is included in your
program. Please understand that we are ready to cooperate with you in
any way in our power when our State is reached.

I thank you in anticipation for your reply, and am,

Very truly yours,

{Signed) John T. Brantley
President

It is safe to say that an invitation such as this would have
been unheard of ten years ago. Other factors have been
responsible for this but we feel that we are justified in assuming
that, in some part at least, the change in sentiment regard¬
ing the public’s interest in the public care of the insane has
been due to the work of popular education carried on by this
Committee.

We are fully conscious of the responsibility imposed upon
us by such confidence in the impartiality and the disinterested
purposes of this Committee. We feel, therefore, that every
effort should be made not only to secure the services of the
best qualified men in the United States for this work but to
have the surveys made and the reports prepared under the
careful supervision of the Executive Committee and Medical
Director of the National Committee.

In our correspondence with official agencies requesting such
surveys it has been made clear in every instance that this Com¬
mittee is interested in the whole subject of dealing with mental

37°

A MIND THAT FOUND ITSELF

diseases in the State, not merely in the institutional phases of
the subject and that, if we undertake a survey, it is with the
understanding that a careful examination will be made of the
organization and efficiency of administrative boards, as well as
of institutions and of the facilities which exist in the com¬
munity for treating mental diseases. It is very interesting
that none of the official agencies to which an outline of our
plan has been presented has felt its desire for a survey grow
less ardent.

Under the appropriation granted to the National Committee
by the Rockefeller Foundation, surveys have been made in
California, Tennessee, Louisiana, Texas, Connecticut, and
Georgia and local surveys have been made in Chicago and
New York. Many other surveys are planned. Surveys are
made without expense to those desiring them; all that is re¬
quired is that an invitation to make them be extended to
the National Committee by the proper authorities. That in¬
vitations are being sent to it by Governors, State Boards and
Commissions, and by State hospital officials also by county
and local officials — is proof that our method, namely, the
study of conditions by a psychiatrist working under the direc¬
tion of officers of the National Committee for Mental Hygiene,
is destined to render obsolete the so-called legislative investiga¬
tion and “investigation” by sensational newspapers.

Surveys of mental deficiency. During the year an important
survey was completed in Nassau County, New \ork, to de¬
termine the social significance and the approximate prevalence
of mental deficiency in a restricted area. In this survey,
which was carried on by the National Committee for Mental
Hygiene under a special appropriation by the Rockefeller
Foundation, a careful estimate was made of the mental condi¬
tion of all individuals in three areas selected for intensive study.
In these areas, the population of which is about 5,°oc,> approxi¬
mately three per cent of the total number were found to be
afflicted at the time or to have suffered previously with some
form of mental disorder, all types of mental deficiency, epilepsy,

A MIND THAT FOUND ITSELF

37i

constitutional psychopathic states and inebriety. About 4,000
other persons in the county were studied, these being selected
from the groups in which abnormal mental conditions seemed
most likely to be found. The mass of data bearing upon the
relation of abnormal mental states to delinquency, dependency
and educational problems collected in this survey is without
parallel and will be of the greatest value in formulating plans
for dealing with mental deficiency. The United States Public
Health Service which has made very important school hygiene
surveys in Arkansas, Delaware, Indiana and Maryland, took
an active part in the survey in Nassau County. The mental
examinations in such surveys are made by medical officers
with special training in psychiatry and they provide trust¬
worthy data as to the prevalence of abnormal mental con¬
ditions in the community.

Mental factors in crime and delinquency. An unusual amount
of attention has been paid during the year to the relation of
mental factors to crime and delinquency. The pioneer work
done by the Juvenile Psychopathic Institute in Chicago has
resulted in the establishment of clinics in connection with
children’s courts in a number of cities. The National Com¬
mittee for Mental Hygiene, through a special appropriation by
the Rockefeller Foundation, established a psychiatric clinic at
Sing Sing Prison on August 1, 1916. The establishment of
this clinic constitutes part of the general plan for the conversion
of Sing Sing into a receiving prison where each prisoner received
will be given most careful mental and physical study. The
clinic has proved not only a valuable means of studying the
psychopathology of crime but has shown that the results of
such studies can be applied very usefully to the conduct of
prison affairs. Efforts are being made to establish clinics
with similar aims in Connecticut, Massachusetts and New
Jersey. Other evidences of the desire to study crime and
criminals from a psychiatrical viewpoint are the appointment
of a resident psychiatrist in the penitentiary and work-house at
Blackwell’s Island, New York City, the reorganization of the

A MIND THAT FOUND ITSELF

372

Police Psychopathic Laboratory in New York City, with four
psychiatrists, one psychologist and two social workers, devoting
their whole time to the task of studying the mental condition
of persons arrested in that city, and the opening of a psycho¬
pathic hospital in connection with the Reformatory for Women :
at Bedford, New York, for the study and treatment of a selected :
group of psychopathic cases among women delinquents.

Inebriety. The mental factors in inebriety are now receiving
much more general recognition than heretofore. Effective
co-operation between those engaged in the study of the in¬
ebriate, the insane and the feeble-minded promises valuable
additions to our knowledge of the underlying causes of inebriety
and its more successful management.

Popular Education

The principal reason for the slow advance in the care of the
insane is the amazing lack of general knowledge regarding
mental diseases and the needs of those suffering from them.

It seems plain, therefore, that it is an important part of our 1
work to stimulate popular interest in the welfare of a class of 1
the sick which has been singularly neglected and thus lay the
groundwork for the creation of local agencies capable of carrying
on effective work for betterment.

Much has been accomplished toward this end during the last
two years and there is evidence of a rapidly growing interest in
mental hygiene. The extension departments of several west¬
ern universities have taken up the subject and have issued
pamphlets dealing with different phases of it. Some illustra¬
tions of this new interest are the inclusion of a chapter on
mental hygiene in text-books and general works, and the
appearance of a number of articles on the subject in the popular
magazines. The National Committee has been requested on
several occasions to arrange symposiums in connection with
important conferences and to outline courses of lectures on
mental hygiene for use in universities.

A number of articles upon subjects related to mental hygiene

A MIND THAT FOUND ITSELF

373

have been referred to us for criticism. No efforts are spared in
giving advice of this sort, for it is felt that the harm which can
be done by the circulation of misleading information makes it a
duty to aid in the preparation of such articles. It is felt that
the information in our possession justifies us in going further
than this, and we regularly furnish information on mental
hygiene for “The Survey,” “The Modern Hospital” and
several other periodicals.

Mental Hygiene Exhibits

It has been found in other organized work for the better
care of the sick or for the prevention of disease that there is no
single agency more effective in popular education than the
exhibit. The success which has been obtained in popular educa¬
tion regarding tuberculosis and hookworm disease and in related
fields of preventive and humanitarian work has been due very
largely to the use of exhibits. With these facts in mind, and
at the suggestion of Dr. Stewrart Paton, we set about preparing
an exhibit on mental hygiene. Psychiatrists, psychologists,
teachers and social workers gave their advice and assistance
most generously. In the exhibit special emphasis is laid upon
the newer and more humane conceptions of mental illness, and
the kindly and efficient methods of care which are replacing
cruelty and neglect. Pictures of the wretched asylum condi¬
tions which unfortunately still exist in many States and of
the methods employed in the early care of the insane were
obtained, and by their side were placed photographs showing
the modern use of occupation, recreation, baths and non¬
restraint in the treatment of the insane. The part played by
the nervous system as the mechanism of adjustment, some of
the types of mental diseases and the conditions upon which
they depend and the control of some of the causes of mental
diseases are some of the other topics treated in the exhibit.
There is also an important section on mental deficiency.

The mental hygiene exhibit was first shown at the 15th
International Congress on Hygiene and Demography, in Wash-

374

A MIND THAT FOUND ITSELF

ington, in September, 1912. It attracted much attention and
was awarded a diploma of superior merit. Since then it has
been shown in New York City, Rochester, Syracuse, New
Haven, Chicago, Buffalo, Albany, Baltimore, Philadelphia,
Boston, Raleigh and a number of smaller places. Requests
have been received from all parts of the country for its use.
Reproductions of some of the charts on a smaller scale and
lantern slides of some of the pictures have been prepared, and
these are freely loaned. A large portion of it formed part of
the Exhibit on Health of the United States Government at
the Panama-Pacific Exposition and won the highest award.

It has been found advisable to hold public meetings in con¬
nection with the exhibit. We have assisted in arranging pro¬
grams and securing speakers for these meetings, and in this
way a great deal has been done to spread information regard¬
ing the care of the insane, the importance of securing early
treatment for those afflicted and regarding the preventable
causes of mental diseases and mental deficiency. Newspapers
and magazines have reported these meetings very fully, and
thus the widest possible use has been made of the information
presented. We have published an illustrated Handbook of
the Mental Hygiene Movement and Exhibit” which is in
constant demand. Charts from this “Handbook have been
published in several journals, and a member of Congress ordered
six hundred copies of one chart to distribute in connection
with a speech in the House of Representatives.

Inquiries

It has been encouraging and especially interesting to have
many spontaneous appeals made to us for information on various
phases of mental hygiene. The following requests for informa¬
tion, which were received during a very short period, may scr\ e
as illustrations:

The medical examiner of a State Bureau of Child Labor asked for de¬
tailed suggestions for making mental examinations of children apph in0 for
labor permits.

A MIND THAT FOUND ITSELF

375

A vigilance association asked for information regarding the relation
between syphilis and insanity and, after receiving it, printed a special
pamphlet on the subject.

The Master-in-Lunacy of the State of Victoria, Australia, asked for
information regarding the early treatment of mental diseases in psycho¬
pathic hospitals and psychopathic wards in general hospitals.

A Tuberculosis Committee asked for information regarding the relation
between tuberculosis and mental disease.

The Director of Physical Training in the public schools of a large city
asked for an outline on mental hygiene to include in a course on hygiene for
teachers.

The Secretary of the Young Men’s Christian Association in Peking,
China, asked for publications on mental hygiene to be placed in a library
used by officials and students.

A clergyman engaged in a “no-license” campaign in the West asked for
charts showing the relation between alcohol and insanity for display in
store windows.

The Director of the Bureau of Social Welfare in a Western university
asked for suggestions for useful fields of effort for an extension division.

A number of teachers of biology and of sociology in universities asked
for data on various phases of mental hygiene to use in their classes.

The editor of a magazine in the South asked for information regarding
the relation of immigration to insanity.

An instructor in sociology in a Southern college asked for suggestions
for a genetic survey of a town of 1,200 inhabitants.

The director of a hospital for the insane in Canton, China, asked for
data on the causes of insanity to translate into Chinese for wide distribution.

A professor in Wellington College, Cape Colony, South Africa, asked for
information regarding mental hygiene and the formation of a mental hygiene
exhibit.

The attending physician of a rescue home for girls asked for advice
regarding psychological and psychiatrical studies of girls in her care.

A number of persons submitted proposed amendments to insanity laws
in different States and asked for opinions as to their form and purposes.

The Bureau of Criminology Research in the Department of Sociology
of a large university asked for advice regarding certain researches into the
relation between mental defect and crime.

These are typical inquiries. An attempt is made to give a
very careful answer in each case. This necessitates, of course,
a considerable amount of inquiry and consultation with those
most familiar with the different problems. It consumes a great

376

A MIND THAT FOUND ITSELF

deal of time, but it seems very desirable to meet such demands
adequately, for our Committee offers to serve as a clearing
house for the nation on the subject of nervous and mental
disorders and mental deficiency, and the care and treatment of
the insane and the feeble-minded.

Publications

To meet the widespread demand for information, the Na¬
tional Committee publishes pamphlets and reports and, in
January, 1917, began to publish as its official organ, a quar¬
terly magazine entitled “ Mental Hygiene.” A description of
this magazine and a partial list of other publications issued or
distributed by the National Committee and by various State
Societies for Mental Hygiene will be found at the end of this
chapter.

Social Service by Correspondence

While it is not one of the purposes of the National Committee
for Mental Hygiene to give aid in individual cases, that being a
function of state and local agencies, many such cases have been
presented in a way making it impossible to withhold advice or
assistance. Several articles relating to the work of this Commit¬
tee, appearing at about the same time in magazines, gave rise
to a Hood of letters from nearly all the States, and from several
foreign countries. Some of these letters had to be answered by
the statement that the advice desired could not be given with¬
out a personal examination, or that publications on the special
topic mentioned were not, at the time, available, but several
hundred of these inquiries have received careful personal atten¬
tion, so urgent seemed the need for advice. Quite a number of
persons suffering from mental diseases have, by this means,
been placed in contact with physicians in different localities.
In order that this may be done effectively, a card-index has
been prepared of the physicians in the different States who are
members of psychiatrical or neurological societies or who are
known to have devoted especial attention to mental diseases.

A MIND THAT FOUND ITSELF

377

It is planned to keep this card-index carefully revised and to
note on the card of each physician the names and file numbers
of the patients referred to him. In this way the future histories
of such cases can be followed. It also serves as a very useful
means of establishing intimate contact with active workers in
psychiatry and neurology in all parts of the country.

Many persons have applied directly for advice regarding
themselves or relatives at the office of the National Com¬
mittee. Those residing in New York State have been referred
to the Committee on Mental Hygiene of the State Charities
Aid Association; those from other States have been advised,
or referred to other societies or agencies near their homes from
which they could receive advice or assistance.

One cannot but be impressed by the helplessness in dealing
with mental illness which these appeals disclose. They pro¬
vide material for a very convincing statement of the need for
local societies or committees for mental hygiene to deal with
personal problems.

Aid in Movements for Betterment

Efforts have been made to assist in every movement for pre¬
vention and to improve conditions among the insane, the
mentally defective, epileptic and inebriate. We have furnished
information or advice, or have co-operated in other ways, in
attempts to secure better laws or to deal with special problems.

One of the stated objects of this Committee is: “To enlist
the aid of the Federal Government so far as may seem desira¬
ble.” The most important step taken by the Committee toward
this end was an interview with President Wilson, which was
arranged by Dr. Stewart Paton in February, 1914. The
importance of the subject of mental hygiene was presented by
Dr. Paton and Dr. Salmon, who represented this Committee,
and each of the points of contact which the Federal Govern¬
ment has with mental hygiene was mentioned. Some of these
are the work of the Public Health Service in general preventive
medicine, but particularly in the mental examination of immi-

37§

A MIND THAT FOUND ITSELF

grants and in the dissemination of information regarding the
causes and prevention of disease; that of the Census Bureau
regarding the insane in institutions; that of the Bureau of
Education; the care of the insane in Alaska and in our insular
possessions; the care of insane Indians; the work of the Govern¬
ment Hospital for the Insane and the recruiting work of the
Army and Navy. In this connection should be mentioned
the introduction of a bill in Congress to establish a Division
of Mental Hygiene in the United States Public Health Service.
This bill has received strong support from all parts of the
country and it is almost certain that it will be enacted into
law. The active aid of the United States Public Health Ser¬
vice will be a powerful accession to the agencies working in
the field of mental hygiene.

This Committee has directed attention to the importance
of the exclusion of the insane and the mentally defective
immigrant. Assistance and advice have been given to several
official Commissions appointed to study this subject. Repre¬
sentatives of the National Committee for Mental Hygiene
have appeared before Committees in Congress and they were
present at hearings given by President Taft in 1913 and one
by President Wilson in 1915. In all that has been done,
especial pains have been taken to make it clear that our in¬
terest in immigration problems relates only to this particular
phase. Better and more humane methods of deportation have
also received attention and some suggestions made by us have
already been put into effect.

M ental Hygiene Conventions

A distinctive feature of the work of the year 19x4 was the
holding of the First Convention of Societies for Mental Hygiene,
under the auspices of the National Committee. This conven¬
tion consisted of two public meetings, held at Baltimore on
Monday, May 25th, 1914, the day before the opening of the 70th
Annual Meeting of the American Medico-Psychological Asso¬
ciation. Active workers of ten Societies and Committees for

A MIND THAT FOUND ITSELF

379

Mental Hygiene took part in the afternoon session, which
had been arranged for the especial purpose of enabling the
active workers to learn what others engaged in similar work
were doing in their respective fields. In the evening the
work of the National Committee was the chief topic for
discussion. Many members of the American Medico-Psycho¬
logical Association attended both meetings, which was grati¬
fying as the date of the Convention had been selected with
that end in view. The second Convention of Societies for
Mental Hygiene was held at New Orleans in April, 1916.

Chief Purposes and Plans of Work of State
Societies for Mental Hygiene

Though all Societies for Mental Hygiene have purposes and
engage in activities common to all, each, influenced by the needs
of the communities served, gives greater attention, perforce,
to some purposes and activities than to others. This, however,
need not keep any Society from adopting such fundamental
purposes and a plan of work as the following, for, as is evident,
the Purposes and Plan can be modified or elaborated as the
work develops.

CHIEF PURPOSES

To work for the conservation of mental health; for the
prevention of mental diseases and mental deficiency and for
improvement in the care and treatment of those suffering from
nervous or mental diseases or mental deficiency.

A PLAN OF WORK

A Society for Mental Hygiene may seek to accomplish its
purposes in such of the following ways as may be deemed
expedient :

Popular Education

By the distribution of pamphlets and reports in which
mental hygiene, the prevention of nervous and mental disorders,
the care and treatment of the insane, the prevention of mental

38°

A MIND THAT FOUND ITSELF

deficiency and the care and training of the feeble-minded, in¬
cluding “backward” pupils in schools, are discussed in popular,
non-technical style.

By means of a Mental Hygiene Exhibit, consisting of charts
which present in a graphic way important facts relating to
mental health, the problems of insanity and mental deficiency
and other related subjects.

By means of public lectures, and by holding Mental Hygiene
Conferences consisting of a series of public meetings at which
all phases of mental hygiene work may be discussed by persons
speaking with authority on the topics presented.

By arousing interest in and helping to create a demand for:

(a) Out-patient departments for mental cases in connection
with hospitals for mental diseases and general hospitals, and
independent of either of these agencies, such, for instance, as
dispensaries and Mental Hygiene Clinics.

(b) Systematic psychiatric as well as psychological exami¬
nation of school children.

(c) Provision for incipient and emergency cases in psycho¬
pathic wards of general hospitals.

(i d ) Psychopathic Hospitals in which cases of mental dis¬
order may be treated in their earliest and most curable stages
and where practical work in prevention and social service may
be done.

( e ) Increased institutional provision for the feeble-minded
and epileptic.

Social Service

By means of social service in mental hygiene, in charge of
an experienced social worker who gives advice at the office of
the Society or, if necessary, goes into the homes of those needing
advice.

By means of Mental Hygiene Clinics, established in con¬
nection with the Society or hospitals, or by means of other
clinics, if they are already available, to which the social worker
and others can take or send cases who apply for advice.

A MIND THAT FOUND ITSELF

38i

By means of after-care work, by which is meant the giving of
advice and assistance to discharged or paroled patients, either
those who have recovered or are regarded as improved, with
a view to preventing their relapse and helping them to re¬
establish themselves in community life.

Surveys

By means of surveys of conditions among the insane and
feeble-minded, including studies of the methods used in various
communities in managing such cases pending commitment to
institutions.

Legislation

By means of adequate appropriations by the State Legisla¬
ture so that liberal provisions for the insane and feeble-minded
will be made, thus doing away with the evils of over-crowding
in existing institutions and making it unnecessary to place
patients in almshouses and other unsuitable places of detention,
pending or after commitment.

By working for laws which will take the responsibility for
the care of patients pending commitment out of the hands of
overseers of the poor and police officials and place it in the
hands of physicians and health officers.

By working for better commitment laws and for an extension
of the use of “emergency” and “voluntary” commitments.

Co-operation with Other Agencies

By co-operating with institutions for the insane and feeble¬
minded and assisting the officials in efforts to secure facilities
for modern methods of treatment.

By co-operating with other charitable organizations, with
State and local Boards, and officials — judges, overseers of
the poor, health officers and with private citizens, such as physi¬
cians, social workers, clergymen and teachers who are so often
brought into contact with persons needing help.

By co-operating with all existing agencies which aim to con-

3§2

A MIND THAT FOUND ITSELF

trol forms of illness and injury which may lead eventually to
mental disorder, such as those interested in the prevention of
venereal diseases, movements against alcoholism, prevention
of infections, regulation of the sale of habit-forming drugs,
safe-guarding workmen in dangerous trades, etc.

By helping in the work of establishing special classes in
the schools so that backward pupils may receive the training
they need and also in order that mental defectives may the
sooner be discovered and given training when it will be of
greatest benefit.

Those interested may secure reports on the active
work of the State Societies by writing to the National
Committee for Mental Hygiene, or by applying to the
Secretaries of the State Societies, whose names and
addresses appear in the directory at the end of this
chapter.

CONCLUSION

There can be no ending to my book more appropriate
than an article which appeared in “Mental Hygiene,” of
the issue of January, 1917, written by Dr. Thomas W.
Salmon, Medical Director of The National Committee for
Mental Hygiene, which I now quote. This article, entitled
“The Insane in a County Poor Farm,” forms part of the
report on a survey made by Dr. Salmon. It is, however,
more than a report; it is a thrilling plea in behalf of the
insane, presented in a most interesting and eloquent way.

It would be difficult to find, in all this wide land, a county
more prosperous, more typically American or pleasanter to
live in than Grayson County. This county contains few cities
— the most populous has only 10,000 people — but a large
rural population is supported in comfort by the fertile soil.
All but two per cent of the population are native-born and there
is a much smaller proportion of negroes than in the state as

A MIND THAT FOUND ITSELF

383

a whole. Most of the wealth produced by the abundant crops
of cotton, corn and cane is reinvested in the county so that
today its taxable property is assessed at more than $45,000,000.

Four miles west of the country seat is the Poor Farm. As
you enter the grounds you come first to a two-story brick
building, recently constructed at a cost of $20,000. In it live
the superintendent and those inmates who are fortunate enough
to be infirm in body but not in mind. Furniture and equip¬
ment are rather scanty but there is enough to meet nearly all
the simple needs of those who must depend upon the county’s
charity. Scattered around the main building are small, wooden
structures, simple and cheap in construction and not in very
good repair, but open to the yard by day and cheerfully lighted
by night. For the most part they are comfortable homes for
the old people, the paralytics, the feeble-minded and the epi¬
leptics who live in them. This county poor farm is an unsuitable
place, as all almshouses are, for the care of the feeble-minded
and the epileptic but, awaiting the time when the state makes
provision for them, they are at least comfortably housed and
protected from most of the dangers to which they would be
exposed in the world outside. The nature of these afflictions
seems to be more understandable to the keepers of poor farms
generally than does that of insanity and, fortunately for the
feeble-minded and the epileptic, cruel traditions have not come
out of the past to influence their care. Such provisions are a
credit to the humanity of the county. You will find few poor
farms in any state very much better than this and you will
find a great many that are not nearly as good.

But what of the insane, who in this great state are kept in
almshouses through failure to provide the necessary accommoda¬
tions in state institutions? Back from the main building, apart
from the little cottages and standing grimly alone, you will
see what Grayson County has provided for them. When you
first see the one-story brick building, with a high, sharp-pointed,
rusty, iron fence on either side of it, you are reminded of a
tomb. It is a tomb, but not for the quiet dead. This tomb is

384

A MIND THAT FOUND ITSELF

for the living whose brains can still know grief and despair and
can still receive impressions from suffering bodies. Coming
nearer to it, you are struck by the appearance of neglect about
the place, contrasting strongly with the neatness of the newer
buildings. This rather picturesque neglect outside is typical
of the tragic neglect of human beings which you will see within
the old brick walls. When you open the door and enter the
building the first impression of a tomb returns for it is chilly —
coming out of the warm October sun — and until your eyes
become accustomed to the shadows you cannot quite distinguish
what Grayson County has hidden here. As the outlines shape
themselves distinctly you see that there is a clear space running
around three sides of the one large room which forms the entire
interior of the building. In the center and across the rear end
of this room are fourteen iron cages, four extending across the
rear end and ten, back to back, down the center. They are
made of iron bars, the backs and adjoining sides being of sheet
metal. Near the top of each solid side are rows of holes about
an inch in diameter. Their purpose is ventilation but they serve
also to destroy what poor privacy these cages might otherwise
possess. Each cage contains an iron prison cot or two swinging
from the wall while a few have rickety beds upon the floor.

In these cages which are too far from the windows in the brick
walls for the sunlight to enter except during the short period
each day when it shines directly opposite them, abandoned to
filth and unbelievable misery, lie the insane poor of this pleasant,
fertile, prosperous, American county. Color, age and sex have
no significance in this place. All of those distinctions which else¬
where govern the lives of human beings are merged in common
degradation here. Men and women, black and white, old and
young, share its horrors just alike. They are insane and, with
the dreadful conception of insanity which here prevails, that fact
alone wipes out every consideration and every obligation except
that of keeping, with food and shelter, the spark of life alight.
When at dusk the shadows deepen, the creatures in this place of
wretchedness cower closer in the corners of their cages for there

A MIND THAT FOUND ITSELF

385

are no cheerful lights here as in the other buildings and when the
darkness blots out everything only the moans and curses of
your fellow-beings in distress remind you that it is not really a
tomb. The outside door is locked at night. There is no watch¬
man to make rounds and see if there are bodily wants to be
attended to. If sudden illness should come at night no welcome
lantern would throw its light across the grass and if the gentle
touch of death should end the sufferings of one of these poor
creatures, the event would be known only by finding a still
form in one of the iron cots at daybreak.

Each morning brings to the men and women here light and
food — as it does to the cattle in the sheds — but it does not
bring to them the slightest hope of intelligent care nor, to most
of them, even the narrow liberty of the iron-fenced yard. One
attendant, a cheerful young man, is employed by the county
to look after the forty-odd inmates who, at the least, comprise
the poor farm population. He used to be a trolley-car conductor
but now he receives forty dollars a month for attending to the
inmates, male and female, who cannot attend to themselves.
He brings back the feeble-minded when they wander off, he
finds the epileptics when they fall in their attacks and he sees
that all are fed. He is called the “yard man”; his duties are
those of a herdsman for human beings. His predecessor, a man
about sixty years of age, is serving a term in the state peniten¬
tiary for an attack upon a little girl who was an inmate of this
poor farm. At his trial it was brought out that he had served
a previous term in another state for a similar offense. Had he
been entrusted with the custody of the county’s funds instead
of its helpless wards his record would doubtless have been
carefully scrutinized before his employment.

The present “yard man” has not the slightest knowledge of
any other kind of treatment for the insane nor has he had the
slightest experience in practical nursing or in caring for the
mentally or physically helpless. He has been employed here
about a year. He found the insane in these cages and he knows
of no other way of keeping them. All but three or four remain

386

A MIND THAT FOUND ITSELF

in their cages all day, crouching on the stone floor instead of
upon the green grass outside. A feeble white woman in bed,
wasted and pale, who apparently has but a few months to live,
was pointed out in one of the cages and the “yard man” was
asked if she would run away if she were permitted to have her
bed outside. He admitted that it was not likely but said that
she was very weak and would fall out of bed. He was asked if
it would be worse to fall out of bed on the soft grass or on the
wooden floor of the main building than on the stone floor of
her cage, but these matters were far outside his experience or
his interests and he had no reply to make. How much more
knowledge and experience would have been demanded of this
young man if Grayson County had seen fit to maintain a me¬
nagerie! No one would think of entrusting the animals to a
man so wholly inexperienced in their care. This young man
might be employed as an assistant but he would not be placed
in charge of an animal house full of valuable specimens.

Do not make the mistake of thinking that the wretched people
who are confined in these cages were selected from a much larger
number of insane inmates of the Poor Farm on account of ex¬
ceptional intractibility or because their brains have been so
dulled that they are no longer conscious of their surroundings.
It is not true but, nevertheless, it might be thought by the
misinformed that among a hundred insane patients a dozen
might be found so profoundly reduced in all their mental
faculties that such a place could make no impression whatever
upon them or so uncontrollable that iron bars were needed to
safeguard their attendants or their fellow-patients. These
people are not a few closely imprisoned for such reasons; they
constitute all the avowedly insane who are housed in the Gray¬
son County Poor Farm. They include persons as fully appre¬
ciative as you or I of the horrors of their surroundings and of
their personal degradation. In one cage is a man who has
delusions which make it unsafe for him to have his liberty in
the community. He has not been allowed outside his cage,
not for a single hour, in three years.

A MIND THAT FOUND ITSELF

387

This place was built twenty years ago. Perhaps the brain
which planned it is now dust; nevertheless, its ignorant concep¬
tion of the nature of mental disease still determines the kind of
care which the county gives to the most unfortunate of all its
helpless sick. Perhaps, too, the hands which laid these bricks
and forged these iron bars are now dead; nevertheless, they
still stretch out of the past and clutch the living in their cruel
grasp. The conception of mental disease which gave to Grayson
County this dreadful place did not even reflect the enlight¬
enment of its own period. Eighty years earlier, Esquirol had
stirred the pity of France by a recital of miseries no worse than
those which you will see in this county today. Many years
before this place existed, Conolly had aroused public opinion in
England to such an extent that it was possible for cages such
as these to exist in only the darkest corners of the land. Thirty
years before this place was built, Dorothea Dix was showing
the inhumanity of almshouse care of the insane in this country
and members of our legislatures were profoundly stirred by
her descriptions of conditions less abhorrent than those which
exist in Grayson County today. Great reforms in the care of
the insane have extended over the entire country since these
walls were built but they have left this place untouched and
it stands today, not a pathetic relic of the ignorance and in¬
humanity of another age and of an almost forgotten conception
of diseases of the mind, but an actual, living reality reproducing,
without a detail lacking, conditions which were described in
pitying terms by the writers of four centuries ago. Standing in
the doorway of this place you can see evidences of the material
achievements of the twentieth century; taking a single step
inside you can see the suffering which the superstition, fear and
ignorance of the sixteenth century imposed upon its insane.

Perhaps, in another year, the governor and the legislature of
this great and wealthy state will listen to the appeals for its
insane poor which have gone up from hundreds of humane
people. Perhaps, next year, the governor and the legislature
will find time to read the report of the condition of the insane

388

A MIND THAT FOUND ITSELF

and feeble-minded which a professor in the state university made
after he had personally visited the jails and the poor farms in
which these unfortunate people were waiting for a summons
to state institutions which never came. Perhaps the resolutions
passed by the State Medical Society and by the Association
of County Judges and County Commissioners — bodies com¬
posed of men who day in and day out see the miseries of the
uncared-for insane — will next year receive the attention of
the governor and the legislature. Then, perhaps, when the
public officials who are the guardians of the honor of the state
become aware of the stain which they have permitted to rest
upon it, a new institution and additional wards at the three
existing state institutions for the insane will be provided so that
all can be cared for instead of a few.

When that is done word will go out to the counties that at
last the state is ready to do its full duty and that the insane
need no longer drag out hopeless lives in the cages of county
poor farms or in the cells of county jails. The clean winds will
then sweep through empty cages at the Grayson County Poor
Farm and dry leaves will dance in the corners where the mothers
and daughters of Grayson County men now cower in filth and
fear and misery. If the old brick building is permitted to stand
at all it will serve then only to start the tears of those who see
it and remember the long years during which a great and
prosperous state was content to permit sick human beings to
remain in such a place. If these things are accomplished, the
insane of the next generation will never know what it is to be
caged like wild beasts, for throughout the state all those who
suffer from mental diseases — rich and poor alike — will be
treated in hospitals just as those with other diseases are treated.
Many will recover, while kindly attention, skilfully directed
occupation and cheerful, comfortable surroundings will amelio¬
rate the lot of those for whom recovery is impossible.

But what of the trembling creatures who will come out of
the darkness and filth of these cells and cages and of places like
them into the light of the state hospitals? Is it still possible

A MIND THAT FOUND ITSELF

389

to make reparation for the neglect and cruelty which they have
suffered? Can a man or a woman be caged for years like a
captive animal and still react to gentleness and kindness? For
some, the progress of their disease alone, without the aid of
man’s inhumanity, has made recovery impossible, but there
are others in the cages at the Grayson County Poor Farm who
would react to the new environment and gain a fair measure
of happiness and contentment. It is not impossible that some
would recover or improve sufficiently to return to their homes.
Such a happy transformation in care would not be an untried
experiment. State after state has wisely and humanely made
provisions for all its insane and passed laws making it illegal
to deny proper care and treatment to any insane person. In
1869, more than twenty-five years before the place in Grayson
County was built, a great state hospital was opened for the
sole purpose of caring for the “chronic” insane. There are
those still living who saw the pathetic company which came
out of the dark cells of the almshouses into the pleasant wards
of this institution. They came — as the insane poor of this
State would come today — in filth and rags, some of them bear¬
ing on their wrists and ankles the shameful marks of handcuffs
and leg-irons. Out of the hundreds who within a few months
passed from utter neglect into humane and skilful care, some
recovered and went back to homes in which they had been
almost forgotten. Others, under patient instruction and
kindly encouragement, took up again household and farm tasks
which they had laid down long ago and lived many years of
contentment in a new world where safeguards were thrown
about them and their damaged minds understood.

It is not enough to appropriate the money needed to provide
a number of new beds in the state institutions sufficient to
accommodate those who now lie in the jails and poor farms and
to amend the cruel commitment laws of the state. The causes
of mental disease are in constant operation and, during the
coming year, not less than 1,000 new patients will require
treatment. Many hundreds of others will still be kept at home,

390

A MIND THAT FOUND ITSELF

to the serious detriment of themselves, their families and the
communities, through survival of the dread of taking the steps
for admission which the existing commitment laws require.
A strong, wise and humane policy of dealing with insanity must,
therefore, be adopted by the state. Every insane person in
the state must continuously receive the protection of its power¬
ful arm and this protection must reach to the most remote
corners.

Perhaps the time has not yet come when the governor and
the legislature will turn their attention to this question — the
one which more deeply affects the honor of the state than any
which is before them. Perhaps still another legislature will
temporize with this solemn obligation. If such be the case,
the issue should not be obscured. The governor and the legisla¬
ture by their failure to provide the accommodations needed in
the state hospitals and to secure the enactment of the laws
necessary to reform the cruel process of commitment will say,
in effect, to the citizens of the state and to the citizens of other
states who, attracted by its opportunities, are considering
making their home there: “Our attention has been called
repeatedly to the sufferings of the insane in the poor farms of
the state. We have had brought to our notice the hardships
which our commitment laws impose upon men and women who
have done no wrong but have developed diseases of the brain.
We have been shown their appalling condition in the county
jails where, during the early period of their illness when the
chances for recovery with proper treatment are greatest, they
are locked up in cells with criminals and denied skilled care,
nursing and even physical protection. We are aware that if
our people are fortunate enough to be able to pay the cost of
treatment in a private sanitarium, it is not necessary to prefer
the charge of insanity against them, arrest them, take them to
jail or try them. We realize that such a distinction in the legal
procedure is undemocratic and is abhorrent to the sense of
justice of our people. We know that fear of the harsh treat¬
ment which the insane receive and of the criminal procedure

A MIND THAT FOUND ITSELF

391

which must be employed to bring them under the care of the
state institutions keeps hundreds in their homes — dissipating
their chances of recovery and imposing a heavy burden upon
their families. We know that there is a strong sentiment in
the state for reform in these matters. We propose, nevertheless,
to do nothing about it.”

This state is calling for settlers. The advantages of its rich
soil, its great undeveloped resources and its extensive transpor¬
tation facilities are being set forth in circulars and advertise¬
ments which are sent broadcast over the country. Chambers of
commerce in Grayson County and in other counties of the
state advertise the advantages to young married couples of
settling in those places. There should be added to such circulars
these words: “However, we must warn you that this state does
not undertake to provide treatment for her insane. If the
young wife by your side has a baby and during her confinement
the delicate mechanism of her brain is injured and she becomes
insane, we will have her charged with insanity, send the sheriff
to arrest her and we will lock her up in jail. If there is no
room for her in a state hospital we will, after her conviction,
put her in an iron cage in the county poor farm and if no vacancy
occurs in the state institution we will keep her there, without
care or nursing. If, while waiting for a vacancy, her condition
becomes ‘chronic’ we will keep her in this cage until she dies,
for preference for admissions has to be given ‘acute’ cases.
If, on the other hand, you and she grow old together and by
some mischance the changes which accompany advancing age
affect the brain of either of you, instead of any other organ, so
that insanity develops, we will arrest you, lock you up in jail
until you are convicted and keep you there or in a cage at the
county poor farm until you die. Other measures have been
proposed in this state but, after mature deliberation and with
full knowledge, the governor and the legislature have decided
to continue the existing policy.”

No one can believe that the present humane governor and
the legislature of this great state will take any such position

392

A MIND THAT FOUND ITSELF

as this. They hold their offices, after all, only to do the bidding
of the people and there can be no doubt in the mind of anyone
who is familiar with the history of this enlightened state that,
once the real truth about the neglect of the insane is realized
and the simple remedy made known, the hearts of the people
will be touched and their wishes in the matter will be com¬
municated to the governor and to the legislature in no uncer¬
tain terms.

For that governor who lends his powerful aid to the libera¬
tion of the insane from the county jails and poor farms of his
state and to the enactment of laws which will forever make it
impossible to keep the insane poor in such shameful confinement
again, there is reserved a place in the esteem of his fellow-men
which the greatest would have been proud to fill. For the
members of that legislature which makes the provisions required
and enacts such laws, there is the reward of knowing that no
men who have sat in the state capitol ever performed a duty
more creditable to their hearts and to their manhood or to the
chivalry of the great American commonwealth which it was
their honor to serve.”

PUBLICATIONS

The attention of the reader is first invited to the follow¬
ing description of the official quarterly magazine of The
National Committee for Mental Hygiene, the publication
of which was begun in January, 1917, at the subscription
rate of two dollars a year, or fifty cents a copy.

MENTAL HYGIENE

A New Magazine in a New Field

AIM

MENTAL HYGIENE aims to present non-technical articles
on the practical management of mental problems in all relations
of life.

FIELD

Adaptation of education to needs of the individual.

Study of mental factors in dependency, delinquency and

crime.

Management of alcoholism and drug addiction.

Control of mental deficiency.

Prevention and treatment of mental diseases and epilepsy.

FOR

All thoughtful readers — especially physicians, lawyers,
clergymen, educators, public officials, and students of social
problems.

MENTAL HYGIENE will present to a wide circle of
readers popular articles on the practical management of
mental problems in all relations of life. These articles

393

394

A MIND THAT FOUND ITSELF

will give the results of study and work in new and vitally
important enterprises. To-day, as never before, atten¬
tion is being directed to mental factors in the problems of
the individual and of society. These factors are of para¬
mount importance in the study and practical management of
delinquency, crime and inebriety. We no longer ignore the
fact that education must meet the needs of children who
present special difficulties of adaptation. The wide-spread
determination to control feeble-mindedness raises questions
of economics, law, and medicine which demand the most
thoughtful consideration. New ideals in the care and
treatment of those suffering from mental disorders are im¬
posing new obligations upon the public authorities. The rec¬
ognition of preventable causes of mental diseases challenges
us to seek in the field of mental hygiene victories compara¬
ble to those achieved in general hygiene and sanitation.

MENTAL HYGIENE will bring dependable informa¬
tion and a new inspiration to every one whose interest or
whose work brings him into contact with these problems.
Writers of authority will present original communications
and reviews of important books; noteworthy articles in
periodicals out of convenient reach of the general public
will be republished; reports of surveys, special investiga¬
tions, and new methods of prevention or treatment in the
broad field of mental hygiene and psychopathology will be
presented and discussed in as non-technical a way as pos¬
sible. No other periodical exists for the express purpose
of serving these ends. It is our aim to make MENTAL
HYGIENE indispensable to all thoughtful readers.
Physicians, lawyers, educators, clergymen, public officials,
and students of social problems will find the magazine of
especial interest.

Subscribers may make checks payable to “Mental

A MIND THAT FOUND ITSELF

395

Hygiene” or to the National Committee for Mental

Hygiene, Inc.

A reduced facsimile of the cover giving the contents of

the first number appears on the following page.

PAMPHLETS AND REPORTS

No. i. Origin, Objects and Plans of the National Committee
for Mental Hygiene. (Out of print.)

No. 2. Principles of Mental Hygiene Applied to the Manage¬
ment of Children Predisposed to Nervousness. By
Dr. Lewellys F. Barker.

No. 3. Summaries of the Laws relating to the Commitment
and Care of the Insane in the United States.
Compiled by John Koren. Revised edition, issued
1917. Postpaid, $1.00 a copy.

No. 4. Some Phases of the Mental Hygiene Movement and
the Scope of the Work of the National Committee
for Mental Hygiene. By Dr. Lewellys F. Barker.

No. 5. Illustrated Handbook of the Mental Hygiene Movement
and Exhibit. Postpaid, 25 cents a copy.

No. 6. The Field, the Work and the Needs of the National
Committee for Mental Hygiene.

No. 7. Purposes, Plans and Work of State Societies for Mental
Hygiene. By Clifford W. Beers.

No. 8. Directory of Societies for Mental Hygiene, with map
showing the growth of the movement.

“Why Should So Many Go Insane?” published by the Mental
Hygiene Committee of the New York State Charities Aid
Association.

“The Right to Marry,” by Dr. Adolf Meyer.

“What is Practicable in the Way of Prevention of Mental
Defect,” by Dr. Walter E. Fernald.

“Opportunities for Nurses and Social Workers in the Field of
Mental Hygiene,” by Clifford W. Beers.

396 A MIND THAT FOUND ITSELF

MENTAL

HYGIENE

VOL, t_ JANUARY, 1917_ NO. l

CONTENTS

Foreword

The Wider Field of Work of the National Committee

for Mental Hygiene . Lcwelly* P. Barker

Some of the Aims of Mental Hygiene . William A. White

Unemployment and Personality . Hannan M. Adler

What Hospitals for Mental Disease Can Do in Mental

Hygiene . . William L. Russell

The Growth of Provision for the Feeble-Minded in

the United States . . : . . Walter B. Fernald

Mental Adaptation . . Frederic Lyman Wells

Organized Work in Mental Hygiene . Clifford W. Beers

The Insane in a County Almshouse . . Thomas W. Salmon

Special Article

The Sub-Normal Child— A Study of the Children

in a Baltimore School District . . . C- Macfie Campbell

Notes and Comments
Book Reviews

PUBLISHED QUARTERLY BY

THE NATION AX COMMITTEE FOR MENTAL HYGIENE, INC.

PUBLICATION OFFICE: CONCORD. N. B.

Editorial Omcr: 60 Union Square. Nett Yore Crrr

CnUrtd at «aw) clan matter at tS* Pott Qffic* at Concent* It. JJ.

A MIND THAT FOUND ITSELF

397

“Public Care of the Insane and Mentally Defective,” by Dr.
Frank P. Norbury.

“Outlines of a State Policy for Dealing with Mental Deficiency,”
by Dr. Thomas W. Salmon, Dr. L. Pierce Clark and
Dr. Charles L. Dana.

“General Paralysis as a Public Health Problem,” by Dr.
Thomas W. Salmon.

“Psychopathic Hospitals and Prophylaxis,” by Dr. Frankwood
E. Williams.

“The Burden of Feeble-Mindedness,” by Dr. Walter E. Fernald.
“What Shall be the Attitude of the Public toward the Recov¬
ered Insane Patient? ” by Dr. Harry C. Solomon.
“Preventable Forms of Mental Disease and How to Prevent
Them,” by Dr. E. Stanley Abbott.

“What Recent Investigations Have Shown to be the Relation
between Mental Defect and Crime.” by Dr. A. Warren
Stearns.

“ Legislation for the Insane in Massachusetts with Particular
Reference to the Voluntary and Temporary Care Laws.”
By Dr. Frankwood E. Williams.

“Mental Pitfalls of Adolescence,” by Dr. Henry R. Stedman.
“Personal Service for the Mentally Afflicted,” by Miss V. M.
Macdonald.

As the list presented is not complete and as only a limited
number of some publications are available , those desiring copies
or information regarding publications of the National or State
Societies are requested to write to the National Committee for
Mental Hygiene, 50 Union Square, New York City.

398

A MIND THAT FOUND ITSELF

LIST OF OFFICERS AND MEMBERS OF THE
NATIONAL COMMITTEE FOR MENTAL HY¬
GIENE, INC., AS OF THE DATE FEBRUARY
i5j i9G

President: Dr. Lewellys F. Barker
Vice Presidents: Charles W. Eliot

Dr. William H. Welch
Treasurer: Otto T. Bannard

Executive Committee
Dr. August Hoch, Chairman
Dr. Lewellys F. Barker Matthew C. Fleming
Dr. George Blumer Prof. Stephen P. Duggan

Dr. Walter E. Fernald Dr. William L. Russell

Finance Committee

Prof. Russell H. Chittenden, Chairman Dr. William B. Coley
Otto T. Bannard William J. Hoggson

Committee on Mental Deficiency
Dr. Walter E. Fernald, Chairman
Dr. L. Pierce Clark Dr. Charles S. Little

Executive Officers

Medical Director: Dr. Thomas W. Salmon

Associate Medical Director: Dr. Frankwood E. Williams

Secretary: Clifford W. Beers

CAn asterisk before a name in the following list indicates that the mem¬
ber serves also as a member of the Board of Directors.]

Members

Mrs. Milo M. Acker, Hornell, N. Y. Formerly a Trustee of
. the Willard State Hospital.

Miss Jane Addams, Chicago, Illinois. Head resident at Hull
House.

A MIND THAT FOUND ITSELF

399

* Edwin A. Alderman, LL.D., Charlottesville, Va. Presi¬

dent of the University of Virginia.

* Mrs. Elizabeth Milbank Anderson, Greenwich, Conn.

Philanthropist.

Dr. Pearce Bailey, New York City. Consultant to the New
York Neurological Institute.

Dr. Chas. P. Bancroft, Concord, N. H. Superintendent of
the New Hampshire State Hospital.

* Otto T. Bannard, New York City. Chairman of the Board

of the New York Trust Company.

* Dr. Lewellys F. Barker, Baltimore, Md. Professor of

Medicine, Johns Hopkins University.

Dr. Albert M. Barrett, Ann Arbor, Mich. Director of the
State Psychopathic Hospital.

Dr. Frank Billings, Chicago, Illinois. Professor of Medicine,
Rush Medical College.

* Dr. Rupert Blue, Washington, D. C. Surgeon-General,

United States Public Health Service.

* Dr. George Blumer, New Haven, Conn. Dean of the Yale

Medical School, Yale University.

* Dr. G. Alder Blumer, Providence, R. I. Superintendent of

Butler Hospital.

Prof. William H. Burnham, Worcester, Mass. Professor of
Education, Clark University.

Dr. C. Macfie Campbell, Baltimore, Md. Associate Profes¬
sor of Psychiatry, Johns Hopkins University.

* Prof. Russell H. Chittenden, New Haven, Conn. Director

of the Sheffield Scientific School, Yale University.

* Dr. L. Pierce Clark, New York City. Consulting Neurologist

to the Randall’s Island Hospitals and Schools.

* Dr. William B. Coley, New York City. Professor of Clinical

Surgery, Cornell University Medical College.

* Dr. Owen Copp, Philadelphia, Pa. Physician-in-Chief of the

Pennsylvania Hospital for the Insane.

* Dr. Charles L. Dana, New York City. Professor of Mental

and Nervous Diseases, Cornell University Medical College.

400

A MIND THAT FOUND ITSELF

* Charles B. Davenport, Ph.D., Cold Spring Harbor, L. I.,

N. Y. Resident Scientific Director, Eugenics Record Office.

* Prof. Stephen P. Duggan, New York City. Professor of

Education, College of the City of New York.

* Charles W. Eliot, L.L.D., Cambridge, Mass. President

Emeritus of Harvard University.

Dr. Chas. P. Emerson, Indianapolis, Ind. Professor of Medi¬
cine, University of Indiana.

Miss Elizabeth E. Farrell, New York City. Superintendent
of Ungraded Classes in the New York Public Schools.

W. H. P. Faunce, L.L.D., Providence, R. I. President of
Brown University.

Miss Katherine S. Felton, San Francisco, Cal. General
Secretary of the Associated Charities.

* Dr. Walter E. Fernald, Waverly, Mass. Superintendent of

the Massachusetts School for the Feeble-Minded.

John H. Finley, LL.D., Albany, N. Y. Commissioner of Educa¬
tion and President of the University of the State of New York.
Prof. Irving Fisher, New Haven, Conn. Professor of Political
Economy, Yale University.

* Matthew C. Fleming, New York City. Attorney-at-law
Horace Fletcher, New York City. Author and lecturer.

* Homer Folks, New York City. Secretary of the State Chari¬

ties Aid Association of New York.

Dr. Charles H. Frazier, Philadelphia, Pa. Professor of
Clinical Surgery, University of Pennsylvania.

His Eminence, James, Cardinal Gibbons, Baltimore, Md.
Arthur T. Hadley, LL. D., New Haven, Conn. President
of Yale University.

Dr. William Healy, Boston, Mass. Director of the Judge
Baker Foundation; formerly Director of the Psychopathic
Institute of the Juvenile Court of Chicago.

Major Henry L. Higginson, Boston, Mass. Banker and
philanthropist.

* Dr. August Hocii, New York City. Director of the Psy¬

chiatric Institute of the New York State Hospitals.

A MIND THAT FOUND ITSELF

401

* William J. Hoggson, New York City. Active in business

affairs and in movements for social betterment.

Mrs. William James, Cambridge, Mass.

* David Starr Jordan, LL.D., Palo Alto, Cal. Chancellor of

the Lcland Stanford, Jr., University.

Harry Pratt Judson, LL.D., Chicago, Illinois. President of
the University of Chicago.

Dr. Charles G. Kerley, New York City. Professor of Pedi¬
atrics, New York Polyclinic Medical School.

Dr. George H. Kirby, New York City. Clinical Director,
Manhattan State Hospital, Ward's Island.

* Franklin B. Kirkbride, New York City. Member of the

Board of Managers of Letchworth Village.

John Koren, Boston, Mass. Formerly President of the American
Statistical Association.

Miss Julia C. Lathrop, Washington, D. C. Chief of Children's
Bureau, Department of Labor.

* Prof. Samuel McCune Lindsay, New York City. Professor

of Social Legislation, Columbia University.

Dr. Charles S. Little, Thiells, N. Y. Superintendent of
Letchworth Village.

Hon. George P. McLean, Simsbury, Conn. United States
Senator from Connecticut.

Marcus M. Marks, New York City. Active worker in move¬
ments for social betterment.

Lee Meriwether, St. Louis, Mo. Author and attorney-
at-law.

Mrs. William S. Monroe, Chicago, Illinois. President of the
Illinois Society for Mental Hygiene.

Dr. J. Montgomery Mosher, Albany, N. Y. Attending
Specialist in Mental Diseases, Albany City Hospital.

Dr. Frank P. Norbury, Jacksonville, Illinois. Formerly Super¬
intendent of the Kankakee State Hospital and at one time
Alienist to the State Board of Administration.

Cyrus Northrop, LL.D., Minneapolis, Minn. President
Emeritus of the University of Minnesota.

402

A MIND THAT FOUND ITSELF

William Church Osborn, New York City. Attorney-at-law and
former member of the New York State Hospital Commission.

* Dr. Stewart Paton, Princeton, N. J. Formerly Associate in

Psychiatry at Johns Hopkins University, now lecturer in
neuro-biology at Princeton University.

Dr. Frederick Peterson, New York City. Professor of
Psychiatry, Columbia University. Formerly President of
the New York State Hospital Commission.

Henry Phipps, New York City. Philanthropist.

Gifford Pinchot, Washington, D. C. Professor of Forestry,
Yale U niversity.

Miss Florence M. Rhett, New York City. Chairman of the
Committee on Mental Hygiene of the State Charities Aid
Association of New York.

Dr. Robert L. Richards, Talmage, Cal. Superintendent of the
Mendocino State Hospital.

Mrs. Charles Cary Rumsey, Wheatley Hills, L. I., N. Y.
Active worker in movements for social betterment.

* Dr. William L. Russell, White Plains, N. Y. Medical

Superintendent of Bloomingdale Hospital.

Jacob Gould Scilurman, L.L.D., Ithaca, N. Y. President of
Cornell U niversity.

Dr. Elmer E. Southard, Boston, Mass. Director of the Boston
Psychopathic Hospital and Professor of N euro pathology in
the Harvard Medical School.

Dr. M. Allen Starr, New York City. Emeritus Professor of
Neurology, Columbia University.

Dr. Henry R. Stedman, Brookline, Mass. Superintendent of
Bournewood Hospital for Mental Diseases.

* Rev. Anson Phelps Stokes, New Haven, Conn. Secretary

of Yale University.

Dr. Charles F. Stokes, Warwick, N. Y. Medical Director
of the New York City Board of Inebriety; formerly Surgeon-
General of the United States Navy.

Sherman D. Tilacher, Nordhoff, Cal. Head-master of the
Thacher School.

A MIND THAT FOUND ITSELF

403

Victor Morris Tyler, New Haven, Conn. Active worker in
movements for social betterment.

* Mrs. William K. Vanderbilt, New York City. Philanthro¬

pist.

Henry van Dyke, D. D., Princeton, N. J. Author ; Professor
of English Literature , Princeton University.

Dr. Henry P. Walcott, Cambridge, Mass. Formerly President
of the M assachusetts State Board of Health.

Miss Lillian D. Wald, New York City. President and Head-
worker of the Henry Street Settlement.

* Dr. William H. Welch, Baltimore, Md. Professor of Path¬

ology at Johns Hopkins University.

Benjamin Ide Wheeler, LL.D., Berkeley, Cal. President
Emeritus, University of California.

Dr. William A. White, Washington, D. C. Superintendent
of the Government Hospital for the Insane.

Dr. Henry Smith Williams, New York City. Author and
editor.

Robert A. Woods, Boston, Mass. Settlement Worker. Head of
South End House.

Members who have died during their term of office :

James B. Angell
Dr. Henry B. Favill
William James
Morris Loeb

Dr. Willl'

Jacob A. Rus
Dr. Arthur C. Rogers
Robert W. Tayler
Dr. Walter Wyman
Mabon

404

A MIND THAT FOUND ITSELF

DIRECTORY OF SOCIETIES AND COMMITTEES
FOR MENTAL HYGIENE

(. Listed in the order of their origin )

The Connecticut Society for Mental Hygiene (organized
May, 1908)

39 Church Street, New Haven, Conn.

Miss V. M. Macdonald, Secretary
Miss Inez Newman, Associate Secretary
The National Committee for Mental Hygiene, Inc.
(organized February, 1909)

50 Union Square, New York City

Dr. Thomas W. Salmon, Medical Director
Dr. Frankwood E. Williams, Associate Medical
Director

Clifford W. Beers, Secretary

The Illinois Society for Mental Hygiene (organized
July, 1909)

157 East Ohio Street, Chicago, Ill.

Miss Elnora E. Thomson, Superintendent
Mrs. Eleanor C. Slagle, Director of Occupations
Committee on Mental Hygiene of The New York State
Charities Aid Association (organized May, 1910; an
outgrowth of an After-care Committee, organized in 1906)
105 East 22nd Street, New York City

George A. Hastings, Executive Secretary
Miss Jessie Taft, Social Service Director
The Massachusetts Society for Mental Hygiene (or¬
ganized January, 1913)

15 Ashburton Place, Boston, Mass.

Dr. Charles E. Thompson, Secretary
The Mental Hygiene Society of Maryland (organized
March, 1913; an outgrowth of an After-care Committee,
organized in 1911)

McCoy Hall, Baltimore, Maryland.

Dr. Charles B. Thompson, Executive Secretary

A MIND THAT FOUND ITSELF 405

The Committee on Mental Hygiene of the Public Chari¬
ties Association of Pennsylvania (organized March,

1913)

Empire Building, Philadelphia, Pa.

Robert D. Dripps, Executive Secretary
The North Carolina Society for Mental Hygiene (or¬
ganized December, 1913)

Dr. Albert Anderson, Secretary, Raleigh, N. C.

The Dayton Mental Hygiene Committee (organized March,

1914)

Address: Mrs. J. Franz Dolina, or Mr. A. G. Knebel,
Dayton, Ohio

The Society for Mental Hygiene of tile District of
Columbia (organized April, 1915)

Dr. D. Percy Hickling, Secretary

1305 Rhode Island Avenue, Washington, D. C.
The Alabama Society for Mental Hygiene (organized
April, 1915)

Dr. W. D. Partlow, Secretary, Tuscaloosa, Ala.

The Louisiana Society for Mental Hygiene (organized
May, 1915)

Dr. Maud Loeber, Secretary

1729 Marengo Street, New Orleans, La.

The California Society for Mental Hygiene (organized
June, 1915)

Miss Julia George, Secretary

638 Phelan Building, San Francisco, California
The Rhode Island Society for Mental Hygiene (organized
March, 1916)

Dr. Frederick J. Farnell, Secretary

335 Angell Street, Providence, R. I.

The Ohio Society for Mental Hygiene (organized May,
1916)

Dr. Thomas H. Haines, Secretary
Columbus, Ohio

406 A MIND THAT FOUND ITSELF

The Tennessee Society for Mental Hygiene (organized
May, 1916)

C. C. Menzler, Secretary
Nashville, Tennessee

The Missouri Society for Mental Hygiene (organized
May, 1916)

Dr. Francis M. Barnes, Jr., Secretary

Humbolt Building, St. Louis, Missouri
The Indiana Society for Mental Hygiene (organized Oc¬
tober, 1916)

Frank D. Loomis, Secretary

88 Baldwin Block, Indianapolis

A MIND THAT FOUND ITSELF

407

HOW YOU CAN HELP

1. Inform yourself regarding the causes and means of

preventing mental diseases and mental deficiency.

2. Emphasize the fact that mental disease is not a crime;

that those afflicted need hospital treatment — not
custody in jails and almshouses.

3. Advocate promptness in treating mental diseases. Early

treatment increases the prospects of recovery.

4. Realize that mental deficiency, although incurable in

the individual, can be controlled in the future through
making provision now for the mentally defective.

5. Acquaint yourself with modern methods of treatment

of mental disorders and lend your support to all
efforts to improve the facilities for such treatment in
your community.

6. Join your State Society for Mental Hygiene. If there

is no such Society in your state write to the National
Committee for Mental Hygiene, Inc., for pamphlets
and reports describing the work of State Societies
for Mental Hygiene.

APPENDICES

APPENDIX I

Mechanical Restraint and Seclusion of Insane

Persons

BY CHARLES W. PAGE, M.D.

Read at State Board oj Insanity Conference, State House, Boston,
Massachusetts, May 17, 1904.

While a certain proportion of the human family must
have suffered from mental disorders for ages past, it is only
about one hundred years since the propriety of controlling
insane persons by the aid of manacles, shackles, chains,
ropes, straps, etc., was especially called into question. At
this stage of the world’s progress, it is difficult for one to
comprehend those former-day doctrines of philosophy,
religion and ethics which overpowered or distorted human
sensibilities to such a degree that compassion for the afflicted
insane had little, if any weight in deciding what measures
should be employed in their treatment; while a vague mys¬
terious horror, or fear of the disease, readily suggested to
friends or custodians barbarous antagonism to its manifes¬
tations. During the political and social upheaval of the
French Revolution, but quite aside from any design on the
part of the revolutionary actors, that great moral genius,
Philippe Pinel, was appointed superintendent of the Bicetre,
the great Paris asylum for incurable insane men. When
Pinel entered the asylum with M. Couthon, a member of the
Commune, they were greeted, it is said, “by the yells and
exclamations of three hundred maniacs, who mingled the
clanking of their chains with the uproar of their voices.”

3*

APPENDIX I

4*

This horrible condition of things had existed indefinitely
without a recorded protest from political officials, church
authorities, or friendly philanthropists. Public opinion had
come to regard such conditions as inevitable, and yet we all
know to-day that the shocking features of that gloomy Paris
prison asylum were due entirely to ignorance, and “man’s
inhumanity to man.” Pinel alone held such an opinion at
that time, and when he requested permission of the govern¬
ment to do away with “the chains, iron cages and brutal
keepers” he was generally regarded as a reckless visionary,
almost an insane man himself. Nevertheless, he removed
the chains from some fifty men at once, and the others sub¬
sequently, without a resulting accident or untowrard event.
Owing, no doubt, in part to unsettled political conditions
in France at that time, this epoch-marking, dramatic inci¬
dent in the world’s progress of humanity was not widely
known or duly appreciated until after many years had
elapsed. Meantime an English Quaker, William Tuke,
becoming sorely distressed with the depleting and repressive
methods to which the insane in the government asylums of
Great Britain were subjected, founded at York, England,
and at his own expense, a hospital for the insane wrhere
lunatics would be treated as sick people, and where gentle¬
ness and patience would, under all conditions, be exercised
towards them.

This humane innovation in lunatic asylum practice
attracted considerable attention in England, and, although
his “Retreat” wras conducted without ostentation, but in
the simple, quiet methods which characterized Quakerism,
it aroused intense hostility, and its methods were denounced
and vilified, especially by those interested in the manage¬
ment of English asylums in which insane inmates continued
to be treated according to the rigorous code of the conserv-

APPENDIX I

5*

ative British authorities. Chains, straps, strait-jackets,
threats, force, coercion, held sway in practically all public
asylums, while the York Retreat continued its gentle and
most successful Non-Restraint ministrations to the insane.
No doubt theories and methods in many English asylums
were in time somewhat modified by the influence of the
York Retreat, but nowhere else were the efficient, advanced,
Quaker principles adopted as the prevailing moral tone and
force of an English institution prior to 1838, when at the
Lincoln Asylum, Dr. Gardiner Hill, seconded by Dr. Charles-
worth, endeavored to absolutely abolish mechanical re¬
straint. But their convictions were regarded as too radical
by the authorities above them, and, as a consequence, they
lost their situations as asylum officers. Yet the time for
a revolution in lunatic hospital management was ripe and
the requisite man, with masterful endowments, was at hand.

In the following year, 1839, Dr. John Conolly, without
previous experience in such work, assumed control of the
lunatic asylum at Hanwell, containing over eight hundred
patients. For some years previously this asylum had been
managed upon lines which were conspicuously mild for
those days. In fact, “it was deservedly considered one of
the best managed asylums in England,” and yet Dr. Conolly
found there forty patients subjected to mechanical restraint,
and, designed for such uses, about six hundred instruments,
of one kind and another, half being leg locks and handcuffs,
with forty coercion chairs. All these he collected in one
room which was called the museum, and from that time no
patient in Hanwell was subjected to mechanical restraint.
In 1844 Dr. Conolly wrote as follows: “After five years’
experience I have no hesitation in recording my opinion
that with a well constituted governing body, animated by
philanthropy, directed by intelligence and acting by means

6*

APPENDIX I

of proper officers, there is no asylum in the world in which
all mechanical restraint may not be abolished, not only with
safety, but with incalculable advantage.” Dr. Conolly
abolished mechanical restraint, not simply because it was
an inheritance from the prison regime to which the insane
were formerly subjected, but more especially because it was
the material embodiment of all prison policy — coercion.
As an English authority has stated it, “what he sought was
not only to abolish the tangible instruments of restraint,
but to substitute the power of a superior mind, guided by
unvarying kindness. He showed by reasoning, he proved
by trial, and he enforced by all the high courage of his un¬
varying patience and his tender heart, the great principle
that the insane are best governed by a law of kindness and
that all coercion applied to them is not only unnecessary,
but hurtful. The credit of first suggesting Non-Restraint
does not belong to Conolly, but it has been well said the
credit of originality is often due, not so much to the man
who first suggests a thing as to him who suggests it in such
a manner as to display its value; or, not so much to him
who sets an example worthy of imitation as to him whose
example compels imitation by its worth. What Conolly
did was not merely to abolish restraint and torture within
the sphere of his personal control, but to render their con¬
tinuance impossible within the limits of civilization. Under
the influence of his example the fetters fell from the limbs
of the lunatic in all English asylums. By example and
precept, by tongue and pen, he labored without ceasing,
in defence of the great principles involved, and he had the
satisfaction of ultimately seeing the practice founded upon
them, more or less closely copied in every asylum in England,
and in many others located in various parts of Europe. He
found the lunatic an object of dread and suspicious horror;

APPENDIX I

he left him an object of commiseration and kindness. He
found insanity regarded as a disease of the mind, he left it
recognized as a disease of the body. He found a madhouse
a prison, and a place of torture without mercy; he left it a
hospital for many and an asylum in fact, as well as in name,
for all inmates.”

This great work, immeasurable in its continued and
ultimate effects, was accomplished only as the result of the
most painstaking personal application to detail in his own
wards and a long continued battle for mercy and justice.
Opposition to his theory and practice, some of it honest
doubting, but much of it ignorant and bitter prejudice,
sprang up and attacked him from all quarters. He met it
first from his own country, from English asylum officials,
and later from Continental critics. He met all opponents
in the true Quaker spirit and his intelligence, his courage,
and his sincerity triumphed, as such qualities always will,
over error and ignorant prejudices. When his detractors
could no longer maintain the commonly believed error that
for mechanical restraint some substitute treatment no
better, perhaps more reprehensible, was adopted, the asser¬
tion that Dr. Conolly’s patients were of a different, a milder
type than those to be found in other asylums, was advanced.
First, in Great Britain it was claimed that the Hanwell
patients were a specially effeminate lot. Then when Non-
Restraint became the general working policy of English
asylums, Continental faultfinders asserted that English
people were a more docile race than native Frenchmen or
Germans. The same untenable assumption is often heard
to this day in extenuation for the continual use of mechanical
restraint in certain hospitals. It will be seriously stated
that the original character of hospital populations varies
from the mild to the aggressive in different sections of a

8*

APPENDIX I

given country, or state, and possibly in contiguous districts,
even. At Danvers mechanical restraint was abolished
about four years earlier in the women’s than in the men’s
wards, not because women patients are less difficult to man¬
age, but for the reasons that an arbitrary position on this
question was not assumed by the superintendent at first,
and because the assistant physicians and supervisors in the
women’s department were especially responsive to sugges¬
tions in this direction. Eventually, when Non-Restraint
had permeated the whole hospital, and when the chief
assistant who had been gradually convinced of the feasibility
of Non-Restraint against his preconceived but honest con¬
victions, remarked in answer to some statement of fact,
which was made one day, “Oh, it’s a comparatively easy
matter to avoid mechanical restraint now because we don’t
have the cases that require it as we formerly did.” Then and
there, the superintendent took occasion to point out that he
had discovered exactly what every man brought into intimate
association with Non-Restraint had discovered; namely,
that Non-Restraint once established in an institution, con¬
ditions which formerly suggested its use rarely if ever occur;
that, as institution after institution had been placed on the
Non Restraint basis, there had been a continuous, successive
re-discovery of the same altered internal conditions, from
the days of Conolly to the present time, a period of some
fifty years. Such being the fact it must be admitted that
this less fractious, less turbulent condition of the insane in
the wards of the hospitals was always the outcome of Non-
Restraint and never the forerunner.

This discloses the real solution of the controversy. Where
restraint is permitted the general spirit of the management
breathes coercion; antagonism, enforced submission. When
Non-Restraint is the undeviating rule, tact, persuasion, and

APPENDIX I

9*

sympathy soften and mellow every act towards the inmates.
The employment of mechanical restraint gives the attendants
a wrong sense of their personal power over patients, such a
physical advantage that they instinctively incline to self-
assertion; to issue peremptory commands; to use ill-con¬
sidered, irritating speech; to give curt answers; to make
threats; in short, to attempt to intimidate all but the most
quiet patients. “Do thus, or so, or you will be sent to the
back wards, you will be secluded, or you will be put in a
strait-jacket,” is the natural style of speech adopted by
attendants when threats and penalties are at their command.
Having thus threatened a penalty, the average uninstructed
attendant concludes that proper hospital discipline demands
its infliction unless the excited, frightened patient meekly
capitulates, a result one could hardly expect with a sane
person, much less with a deranged, apprehensive lunatic.
Even well meaning attendants naturally fall into such errors
unless carefully drilled and faithfully watched. Fresh re¬
cruits are constantly entering the nursing service, and only
by individual work with them can the highest ideals of a
qualified nurse be instilled into their minds.

I cannot understand how the superintendent of an insane
asylum can satisfactorily regulate the use of mechanical
restraint if he permits its use. He may reserve to himself
the decision as to whether or not it shall be used in each
case. But the chances are that he only learns of the final
links in the long chain of circumstances which connect the
special overt acts of the patient with some affair, trivial it
may be, that originated the trouble, and which, by inju¬
dicious treatment from the attendants, ultimately assumed
serious phases. Under such conditions the supervising
medical officer, when he authorizes the use of restraining
apparatus, simply endorses the judgment of the attendants.

APPENDIX I

IO*

Let it be understood that restraint can be used only in ex¬
ceptional cases, and exceptional cases will be brought to his
attention too frequently.

An eminent English authority has recorded his convic¬
tions that “there can be no real compromise between the
frequent use of mechanical restraint and its entire abolition.
One system or the other must predominate in every asylum.”
In managing the insane the first impulse of the attendant
is to assume authority or superiority, and give commands
or orders, often with a penalty for disobedience expressed
or implied. When the Non-Restraint principle is adopted,
attendants are under no temptation to utter such threats.
Thus, they are dispossessed in advance of that which, in the
great majority of cases, occasions troublesome friction
between themselves and the patient. When driving patients
is out of the question, attendants must induce or lead them.
They must exercise the art of persuasion, of pleasing, of
soothing. Thus fears will be allayed, confidence will be
gained, and a relation of helpfulness and friendship be
established. In such arts the capacity of the individual
nurse varies; but all who approach patients in the right
spirit, with the desire to befriend which qualifies attitude,
tone of voice, choice of words, expression of the eye and use
of the hands, can demonstrate the power of a kindly dis¬
posed, orderly mind over a disordered intellect. No doubt
there are insane patients who would suffer no personal
injury, mental or physical, by the application of restraining
apparatus. Indeed, I am willing to concede that cases may
arise where, could their management be absolutely dis¬
sociated in its influence from all others, mechanical restraint
might be the most expedient treatment. But, in an institu¬
tion for the insane, it should be only the last resort, since
so much for the general good of the inmates depends upon

APPENDIX I

II*

the nursing morale of the hospital, and the demoralizing
ill effects of exceptions to the Non-Restraint rule are so
pernicious and wide reaching, that officials or nurses should
use mechanical restraint only when satisfied beyond ques¬
tion that its use or neglect would determine the life or death
of the patient.

Perhaps I speak with assurance, but I worked out this
problem at Danvers, where mechanical restraint was abol¬
ished deliberately. As has been stated, its use was dis¬
continued in the female wards four or five years before it
was wholly given up in the male department. The annual
report of the Danvers Insane Hospital for 1897 contains
comments upon this subject. To quote: “I am aware that
many persons regard Non-Restraint in lunatic hospitals as a
fad of enthusiasts. I often hear this subject discussed in
such terms, or dismissed with such indifference, that I infer
comparatively few physicians even view this question from
our standpoint, and therefore deem it proper to explain why
mechanical restraint is abolished at Danvers. Mechanical
restraint may be, and certainly is, used occasionally upon
patients in general hospitals with no injurious consequences;
but conditions in general hospitals and lunatic hospitals
are so dissimilar, this fact proves little. I formerly per¬
mitted the use of restraining apparatus upon patients, en¬
deavoring to limit its use to rare and exceptional cases.
While working under this policy, I not only found it difficult
to decide upon cases, and to convince the nurses that restraint
was seldom necessary, but every exception in favor of me¬
chanical restraint seemed to weaken the courage and resolu¬
tion of the nurses, as well as to diminish my influence and
control over them. Then, too, as long as nurses understood
that straps and jackets could be employed as final measures,
they not only relinquished mild efforts too quickly, but were

APPENDIX I

12*

inclined to assume a dictatorial, oppressive manner towards
patients upon slight occasions; and this spirit of coercion
as evinced by the nurse in his or her attitude towards the
patient was, according to my observation, the starting-point
of the trouble with refractory patients in the great majority
of cases.

“Now that mechanical restraint is discarded, the nurses
understand that they will be regarded as incompetent unless
they can manage the patients in their charge without resort
to violent measures, seclusion and restraint. Intelligent
nurses do not complain of such restrictions. They appear
ambitious to demonstrate that a trained nurse can manage
the insane without the fetters and instruments which are
relied upon in such cases by the unprofessional keeper.
Certainly, the Non-Restraint rule has advanced a kindly,
humane spirit in our wards as no other measures could have
done. Nurses have no temptation or power to control
patients by threats of punishment. Under such conditions,
whatever native tact, art, and persuasive powers the nurse
may possess are rapidly developed; and, as a result, more
sympathetic, friendly relations are early established between
nurse and patient, and the common annoyances and irrita¬
tions formerly experienced by both parties are largely avoided.
The beneficial effects thus ensuing, when considered in the
aggregate, are of such magnitude, I am resolved that the
Non-Restraint rule shall not be broken except as a last
resort, as a life-saving measure.”

Since that time, I have been responsible for the custody
and treatment of more than six thousand insane persons,
not one of whom was restrained with mechanical appliances
by my orders or within my knowledge. Because a former
superintendent purchased restraining apparatus and ex¬
perimented with it upon not more than two patients and for

APPENDIX I

13*

a period not exceeding one week, according to reports, the
makers of such apparatus continue to circulate a statement
that the Danvers Asylum is one of their patrons. I have
seen patients who in their quiet moments requested that,
in their recurring attacks of excitement, a strait-jacket
might be applied. But, in such cases, I have found there
existed a morbid, hysterical element, which, when properly
treated, did not develop the frenzied periods the patient had
come to expect and dread. I have dealt with trying subjects.
A native of West India was once transferred to Danvers
from another state institution, because, if the nurse who
conducted the transfer knew the facts and stated them,
“they could not manage her.” “But you have had her in
restraint,” I said. “Oh, yes,” the nurse replied, “she has
been let out of restraint only two hours a day.” This
patient was destructive, suicidal, and vicious. She re¬
mained in the Danvers hospital three years and nine months,
and was never restrained there by the aid of mechanical
appliances. In time, she greatly improved; she took her
meals for a considerable period in our congregate dining
room, and for a time before leaving was granted limited
parole of the grounds. I confess that the case of this patient,
who was epileptic, therefore hopeless as far as recovery was
concerned, was a severe tax upon the mental and physical
conditions of both officers and nurses, greater, perhaps,
than the results to this single individual warranted. But
the Non Restraint principle, the animus of an ideal hospital
regime was at stake, and its preservation was, in my opinion,
worth all it cost. Besides, I regard the self-sacrificing care,
the sympathy and the patience exercised by the nurses who
accomplished such excellent results in this case, as examples
of moral heroism, quite as creditable as many that have
received public approbation and medals of honor; and who

APPENDIX I

14*

will put a price on moral heroism? Besides, what official
or nurse, imbued with proper pride in his or her profession,
is willing to admit that science, training, and skill have no
methods with the insane superior to those instinctively sug¬
gested to the mind of an inexperienced, uneducated layman?
Too much emphasis cannot be put in the assertion that it is
less the machinery employed in mechanical restraint than
the spirit of coercion, which its employment fosters, that
should be abolished from an insane hospital.

A prominent general practitioner of medicine once re¬
marked to me, “This talk about Non-Restraint is all rot; we
use it at times in our general hospital.” This gentleman did
not appreciate that the relationship existing between patient
and nurse in the general hospital differs widely from that
necessarily established in the insane hospital. He did not
take into account the fact that, in the general hospital,
where every act of the nurse is under the constant watch
of rational observers, the use of restraint is safe-guarded as
it cannot be in the insane hospital wards. Nor did he com¬
prehend this important distinction, that in the general
hospital, the chief end to accomplish by restraint is the
control of the patient; while in the insane hospital, the
prime requisite for the highest success in management is
the intelligent self-control of the nurse.

The argument against mechanical restraint applies in
large measure to seclusion of the insane. While seclusion
is, in some degree, less demoralizing in its effects or its in¬
fluence upon the nursing staff of an institution, only in rare
and exceptional cases, can its employment be remedial or
beneficial. If, as Conolly said, “Restraint is Neglect,”
it is doubly true that seclusion is neglect. If used, it should
never be prolonged. As a rule, thirty minutes’ seclusion
is worth, as a corrective measure, more than twenty-four

APPENDIX I

15*

hours of the same treatment. Next to execution, solitary
confinement is the severest doom that legal tribunals can
pronounce upon hardened criminals. Solitary confinement
is universally considered to be painfully trying to a sane
mind. How can it be improving to a deranged man, shut
away from associations with human beings, incapable of
comprehending the logic of his position, consumed by de¬
lusions or burning with revengeful indignation towards the
authors of his imaginary wrongs ?

Can all the insane be managed without restraint or seclu¬
sion? Conolly always said “Yes” to that question. When,
after consulting with him, superintendents of other institu¬
tions remarked that they would return home and try Non-
Restraint in their asylums, he would coolly reply, “You
will succeed if you are in earnest.” Some Continental
hospital officials were well-nigh exasperated by Conolly’s
calm, significant, qualified prediction, “You will succeed if
you are in earnest.” He had been in earnest. In order to
attain his ends at Hanwell, he had devoted a surprising
amount of personal attention to each trying, difficult patient,
visiting such both by day and night, watching the conduct
of attendants towards such cases with unceasing vigilance.
Superintendents who hope to accomplish results which
made his name famous as a philanthropic physician and skil¬
ful asylum manager must imitate the example of Conolly to
the extent, at least, of giving considerable personal attention
to those patients whose conduct taxes the patience and wits
of the nurses. The successful management of the turbulent
insane without restraining apparatus cannot be accomplished
by simply forbidding its employment.

Rules to meet the exigency of every possible situation
cannot be formulated in advance, since the various patients
will present such dissimilar, unexpected and individual

APPENDIX I

1 6*

features of difficulty. Therefore, the hospital rule maker,
the commanding official, must intimately share with the
nurses the labor and responsibility which trying cases force
upon the management. I believe it is an important part
of the system of instruction that each instance of friction
between nurse and patient receive consideration from the
superintendent, and, if thought best, that the involved nurse
be commended when she acted judiciously, or be admonished
when evidently failing to exercise due art as a trained nurse.
When the position of the nurse was faulty, the better way
should be pointed out. Such methods teach, and the
physician who adopts them is soon able to identify those
nurses who have special aptitude for their wmrk, and can
select for the difficult posts those best qualified for the
trying duties. Nurses who possess self- poise, capacity for
tact, and power to rapidly conceive expedients will naturally
succeed. I have seen slender, light-weight girls manage
the hardest wards quite as well as those of large stature.
As an aid towards the development of such nurses at Danvers,
each ward is supplied with special report slips to be used
according to directions printed on each slip; viz., “When a
patient escapes; attempts to escape; receives an injury,
accidentally or otherwise; has to be handled with force, or
is secluded; the attendant engaged in the affair, or the one
in charge of the patient at the time, must send a written
report to the medical officer in charge of the ward in which
the patient belongs, who will countersign the same and for¬
ward it to the office of the superintendent.” At a con¬
venient time, the patients thus reported are visited by the
superintendent with the slip in hand, when such personal
investigation and instructions as may seem necessary can
be given.

Being in earnest is the solution of the Non-Restraint ques-

APPENDIX I

17*

tion. The ruling authority over and above the nursing staff
must be in earnest; and this signifies clear insight as to
the evil done and its remedy; certainty as to what can
be done with the insane by virtue of patience, sympathy
and tact; with determination, watchfulness, faith and en¬
thusiasm.

APPENDIX II

A pamphlet issued by the Department of Commerce
and Labor, May 22, 1905, under the head “Daily Con¬
sular Report, No. 2264,” contains an article by Hon. Frank
H. Mason, then Consul-General at Berlin, Germany. It
is entitled “Modern Hospital for the Insane,” and reads as
follows :

“Among the valuable lessons which most other nations
can advantageously learn from the experience and practice
of Germany is the scientific treatment of insanity in its
incipient stages as a physical and possibly curable disease.

“Notwithstanding the rapid and deplorable increase of
mental diseases which has followed the stress and strain
of modern business and social life, it must be admitted that
in the United States, and even in Great Britain, govern¬
mental beneficence has not progressed beyond the eleemosy¬
nary function of providing asylums in which the more or less
hopelessly incurable victims of insanity, who have become
a burden and menace to their friends, can drag out in safety
and physical comfort the remnants of their stricken lives.
If here and there a private clinic has made a hopeful begin¬
ning with the pathological treatment of mental diseases,
it has been due to individual initiative, and the ministra¬
tions of such institutions are restricted mainly to patients
of the well-to-do class, leaving the great majority of poor
unfortunates to drift on to a stage of mental alienation in
which they become dangerous to themselves and to those

18*

APPENDIX II

19*

about them, and therefore entitled to the attention and
support of the State. Germany has taken a long and im¬
portant step beyond this, and to give a simple statement of
the means employed and some of the results attained is the
motive and purpose of the present report.

“There are in this country twenty-two psychiatrical
clinics or hospitals for the treatment of mental diseases.
Most advanced and worthy of study are those located at
Kiel, Giessen, Strassburg, Berlin, and, latest and most im¬
portant of all, the new clinic at Munich, which, in all that
relates to perfection of equipment and arrangement as well
as to the scientific enlightenment of methods employed,
stands undoubtedly at the head of all institutions of its class
in this or any other country.

“In his forthcoming treatise on the treatment of mental
disease Dr. Stewart Paton of Johns Hopkins University,
to whose suggestion and kind assistance this report is prima¬
rily due, states the essential conditions and requirements of
a modem hospital for the insane as follows:

“1. Ease of access. The institution should be near to
or within the limits of a city.

“2. A limited capacity, in order that every individual
may be made the subject of special study.

“3. Perfect construction, equipment, and organization,
in order that a thorough and energetic treatment can be
undertaken for all patients for whom there is hope of re¬
covery.

“4. A relatively large staff of physicians and nurses.

“ 5. Ample provision not only for the teaching of students,
but also for the prosecution of post-graduate investigations
and research in clinical psychiatry, psychopathology, and in
anatomy and pathology of the nervous system.

“6. The ready admission of patients and their prompt
23

APPENDIX II

20*

transference, when necessary, to other more appropriate
institutions and provisions for outdoor and voluntary pa¬
tients.1

“The Psychiatrical Clinic at Munich fulfils, to a degree
probably not elsewhere attained, all these requirements and
conditions. It was built by the city of Munich at a cost of
$500,000. It is conveniently located and accessible; it is in
close touch with the medical department of a leading uni¬
versity; and it has for its field of usefulness a city of 580,000
people. It has accommodations for no bed patients of both
sexes, besides a large dispensary on the ground floor for the
treatment of voluntary patients who come in at stated periods,
but live otherwise at home. Although opened only a few
months ago, the clinic will have treated not less than 2,000
patients before the close of its first year.

“The edifice . . . was completed last year, and includes
the central or administration building, with two wings, which
form the front and sides of an open court or garden. In
the central structure are located laboratories for pathologi¬
cal, chemical, and psychological studies, a fine medical
library, rooms for the reception and examination of patients,
and the private rooms of the director. The apparatus and
facilities for every form of research connected with anv
question relating to preventing, detecting, and curing in¬
sanity are as elaborate and perfect as experience and up-to-
date science can suggest.

“Among various special features are bathrooms, arranged
with tubs in which the water can be maintained indefinitely
at a given temperature, and in which excited patients may
be kept without restraint for hours, to splash at will or even

1 For detailed description of a modern Psychopathic Hospital see
“Psychiatry” (Chapter VI), by Stewart Paton, M. D., published 1905, by
J. B. Lippincott Company.

appendix II

21*

to sleep, using rubber air cushions as pillows — a soothing
and highly efficacious form of treatment at certain stages of
mental disease. A small iron door in the wall opens into an
oven, in which hot towels are always within reach, to be used
in rubbing down the patient on leaving the bath.

“A ward of the ordinary size contains space for from five
to ten beds and has among its equipment a small electric
cooking stove for heating water or milk, preparing eggs,
toast, and other food, a movable bathtub on casters, and
electric lights that can be so controlled as to give any desired
degree of illumination.

“The lecture room has accommodations for two hundred
and forty students, and is lighted by incandescent electric
lamps so placed as to project the light upward against a
white ceiling, so as to give a clear, but mild, diffused light,
strong enough for every purpose, but without glare. If,
during a day lecture the professor wishes to use kinetoscope
or magic lantern illustrations he touches a button, and black
shades running in grooves at each window, drop and make
the interior dark. Another knob is touched and the kineto¬
scope or lantern picture is thrown upon the screen and the
lecture proceeds without a moment s interruption.

“The hospital is not free. Patients are divided accord¬
ing to their means into three classes, but the treatment and
medical services are precisely the same to all, according to
their condition and necessities. Patients of the first, second,
and third classes pay respectively $2.38, $1.36, and 71 cents
per day, everything included. Absolutely no restraint is
used. All the wards are perfectly warmed, ventilated, and
lighted; the walls are of bright, cheerful colors and hung
with cheap but good pictures that appeal to a correct artistic
taste. In the corner of each occupied ward is a seat for a
nurse at a table provided with an electric light so arranged

APPENDIX II

2 2*

that she may read without disturbing the patients. In the
wall are three small niches, each covered with a locked iron
panel or door, to which the nurse has the key. By unlocking
one of these doors electric light is turned on throughout the
ward, either suddenly or gradually, as may be desired.
Opening the second door calls the director or house physi¬
cian, and the third is a time recorder, by opening which at
brief stated intervals the nurse records on a dial in the
director’s office the fact that he or she has been awake and
in constant attendance.

“The medical staff of the Munich Psychiatrical Clinic
includes as director Prof. Dr. Emil Kraepelin, one of the
foremost German specialists in mental diseases; First Assist¬
ant Physician Doctor Gaupp, and Doctor Altzheimer,
assistant physician and director of the laboratory. These
and two other assistant physicians are paid; the others are
young physicians who receive for their services free board
and lodging, but no other compensation. The educational
advantages offered by the clinic form one of its most valuable
assets. These include oral and clinical instruction not only
to medical students, but to practicing physicians who wish
to become competent practitioners or specialists in mental
diseases, and to lawyers who seek to specially qualify them¬
selves for practice in the large and unfortunately growing
class of cases that involve questions of mental responsibility.
The clinic also serves as a tribunal of highest authority to de¬
termine the condition of patients who are involved by charges
or litigation which hinge on the fact or degree of mental ab¬
erration. Such a patient is kept under expert observation
and subjected to tests that finally give a definite diagnosis of
his condition, which is no longer left to be decided by the
academic opinion of a medical expert, caught by the artful
hypothetical questions of a shrewd opposing attorney.

APPENDIX II

23*

“Thus constructed, equipped and administered the
modern psychiatrical clinic in Germany meets and fulfils
two fundamental needs that exist in greater or less degree
in every city or large town in the United States, namely,
that of better facilities for the skilful treatment, care, and
possible cure of cases of incipient and acute insanity; and,
secondly, adequate provision for instruction in treatment
and in the investigation of practical problems upon the solu¬
tion of which must depend the arrest of increasing insanity
among the people of the State. Its inestimable service to
the community is that it provides for saving an indefinite
but considerable percentage of the victims of incipient
mental disease, and restores them to lives of usefulness,
instead of leaving them to degenerate into a menace to
society and a burden to the State. It provides the most
consummate examination and treatment at a stage of the
disease when there is the most chance of averting or arrest¬
ing an attack of real insanity. It detects and takes timely
charge of the smaller but important class of patients who,
without the knowledge of their friends, are on the border
line of insanity, and liable at any time to become suddenly
dangerous to themselves or others.

“ Its beneficent function is the prompt application of every
known resource of detection and prevention to the whole
insidious group of mental diseases which have become a
penalty of the intense, over- wrought life of modern society,
or are induced by poverty, self-indulgence, or inherited
tendencies. Public benevolence and private philanthropy
can fulfil no higher or more valuable purpose than to bring
the ultimate resources of science to the support of a cause
like this.

“Frank H. Mason, Consul-General”
Berlin , Germany , April 8, 1905.

APPENDIX III

Pavilion F, A Department for Mental Diseases of
the Albany Hospital. Delivered before the
Thirty-fourth National Conference of Charities
and Correction, at Minneapolis, Minn., June 18,
1907.

BY J. MONTGOMERY MOSHER, M.D.

Attending Specialist in Mental Diseases, Albany Hospital, Albany, N . Y .

[Reprinted from the Proceedings.]

On the sixth of December, 1899, seven physicians of
Albany, New York, petitioned the board of supervisors of
the county to erect a “building for the temporary care
of insane patients,” directing attention to the fact that “ the
process of commitment to a hospital for the insane is com¬
plicated and often requires several days, during which time
the patient may be protected by his friends as best they can,
or, in event of active manifestations of insanity, endanger¬
ing himself or others, be placed in the jail.” The petition
was favorably considered and a law was enacted appropriat¬
ing eighteen thousand dollars “for the construction and
furnishing of a reception pavilion in connection with the
Albany Hospital, for the detention and care of persons
afflicted with nervous and mental disorders.” The Albany
Hospital is a private corporation, under the administration
of a board of governors, elected annually by subscribers,
built on land granted by the city, and providing wards for
the care of both private and public patients. The erection

24*

APPENDIX III

25*

of the so-called “Reception Pavilion” was contingent upon
“a contract between the Albany Hospital and the County
of Albany, that the said hospital will maintain and manage
the said pavilion, and will agree to receive and accept for
detention or treatment in said pavilion, all public patients
from this county or any of the cities or towns thereof, upon
the same terms as public patients are received and cared for
from the various towns of this county, at such hospital.”

The conditions leading to this action were particularly
painful. The insane of the State of New York are main¬
tained by a State law. The State is divided into hospital
districts, Albany being in the district of the Hudson River
State Hospital at Poughkeepsie, distant seventy-five miles.
There was no opportunity for the treatment of a case of in¬
sanity other than by a commitment to this hospital. The
commitment is a complicated legal process, consisting of a
petition by any person with whom the patient may reside,
by the nearest available relative or by a proper public official,
annexed to the certificate by two qualified physicians, of an
examination to have been made jointly within ten days
before the granting of an order, and to contain a statement
of “the facts and circumstances upon which the judgment
of the physicians is based, and show that the condition of
the person is such as to require care and treatment in an
institution for the care, custody and treatment of the in¬
sane.” The petition and certificate, properly verified, con¬
stitute the application, notice of which shall be served
personally, at least one day before making such applica¬
tion, upon the person alleged to be insane. If the judge
to whom such application is made is satisfied that the
alleged insane person is insane,” he may “issue an order
for the commitment of such person,” or he may, “in his
discretion, require other proofs.”

2 6*

APPENDIX III

A later amendment to this law provides for “emergency
cases,” who need “immediate care and treatment,” or who
are “dangerously insane,” and may be received in an insti¬
tution upon the certificate of lunacy and petition for five
days pending the judicial order.

In brief, a patient who is suffering from disease of the
mind, the most threatening calamity of life, must be so far
advanced in the disease and so disordered in action or in
speech as to satisfy a lay tribunal of the necessity or justi¬
fication of the forcible deprivation of his liberty, must be told
that he is “insane,” must be “adjudged insane,” and “com¬
mitted” by a court to an institution for the insane, before
he can receive the treatment best adapted to the restoration
of his health.

In so far as the “Insanity Law” of New York relates to
the care, custody or protection of the insane, it is definite
and effective ; but as an obstacle to the prompt early
treatment of mental disease, it must be regarded as a
medical barbarism. This discrimination against the mental
patient places him in a different light than the sufferer from
a physical ailment, although the pathological processes are
more delicate and intricate and demand the most painstaking
consideration. It is impossible to conceive of a patient with
pneumonia or a broken leg applying to a court of law for
medical or surgical care, but such is the necessity of a mental
case.

The man who has overtaxed his nervous system suffers
first from insomnia. Insomnia is a manifestation of irri¬
tability, which is the earliest expression of exhaustion. It
indicates that the excessive momentum of the work of the
day is carried into the night, and that normal relaxation and
recuperation do not follow. The train of thought is beyond
voluntary control, and this automatic mental activity soon con-

APPENDIX III

27*

tinues throughout the day and night. The patient states that
his thoughts are “ running away with him.” He is also con¬
scious of inability to concentrate his attention, which, as a
layman, he usually describes as loss of memory. This
mental unrest early becomes a source of anxiety, and the
attempt is unfortunately made to obtain relief by sedatives;
the overshadowing symptom of irritability is treated and
the underlying pathological state of exhaustion ignored.
The result is disaster. The use of debilitating drugs upon
an already depleted organism intensifies the condition,
interferes with function, obstructs the secretions, prevents
metabolism, and the products of decomposition accumulate
as poisons, to add their damaging effects. Strange thoughts
and fancies fill the mind of the patient, of the extraordinary
character of which he is partially or at times fully con¬
scious, and of which he is willing to accept an explanation.
This is the point of progress of the ailment which has been
described as the “borderland of insanity.” It is the true
psychological moment at which a misstep may precipitate
disaster, and proper treatment may avert a long and dan¬
gerous illness. The family look upon the patient with
apprehension and with awe. The actions, manner and
characteristics of one dearly beloved are changing and his
companions are not educated to the interpretation or man¬
agement of the altered personality. Evasion, indirection,
deception, falsehood, contradiction, chiding and even vio¬
lence, bewilder the patient, intensify his irritability and con¬
firm his doubts, when the simple truth, a frank revelation
to him of the morbid origin of his fancies the only source
of mental relief — is almost never spoken. They appreciate
the mental disorder, its threatening aspect and possibilities,
but stand in awe of the formidable judicial declaration of
insanity. The opprobrium attached to a confession of

28*

APPENDIX III

mental obliquity weighs more heavily than the desire for
relief. Delay and mismanagement follow until the patient,
delirious and desperate, has committed some offence against
the law, or has become flagrantly incompetent, when, often
too late, he is placed in the hands of physicians who under¬
stand his condition and are trained in the use of therapeutic
measures for relief.

The shock of it all is frightful. In this age of ideals and
stress, many who strive for the highest rewards of cultivation
of the nervous system, the attainment of a lofty ambition,
suffer moments of fatigue and depression, the penalty of
overwork. The impending calamity, in which individuality
is felt to be slipping away and merging into incompetency
and lunacy, is apprehended and feared. Relief is sought,
too often in vain, for men and measures are not provided.
Here lies the opportunity of individual prophylaxis, and here,
between the home and the asylum, the general hospital
may intervene.

Fortunately for the proposed project, conditions at the
Albany hospital were peculiarly favorable. A new institu¬
tion had been constructed, consisting of a series of buildings
on either side of a central corridor or axis, providing wards
for public and private patients, an operating theater,
nurses’ house and administration. The pavilion for mental
cases was placed in the rear of the nurses’ house, distant
from the general wards, and from the publicity of the
central corridor.

The floor plan was designed with an eye to the needs of
all classes of patients. It was anticipated that both tur¬
bulent and quiet cases would be received, and that the
comfort of each must be promoted. There were two depart¬
ments, separated by a heavy partition wall and double doors,
in the rear of which were two guarded rooms, where noise

APPENDIX III

29*

might be confined. At the end of the first year it was found
that this provision was inadequate and the rear section was
enlarged to provide ten rooms, with a day room or sitting
room on each floor. Six of these rooms were approached by
a communicating cross hall, so that the disturbed patients
are removed from the general ward. This plan serves the
double purpose of adequate provision for the excited patient
and protection for others. Shouting, rattling of doors and
windows, striking the walls, are manifestations of mental
disorder just as elevation of temperature is a symptom of
fever, and mental disorder, as fever, is often self-limiting.
The patient should be placed under proper conditions and
carried intelligently through the attack. Excretion of waste
products is to be promoted, the state of nutrition improved,
and normal functional activity of the organism restored.
These are medical problems of transcendent importance
and direct the attention and the therapeutic efforts to the
patient himself. Methods sought to be justified under
the vicious plea of expediency are anticipated, and forcible
suppression of symptoms is avoided unless for his good.
Harmful sedatives and other coercive measures for pre¬
venting disturbance are too often used, to the detriment of
the patient and for the benefit of others.

The first consideration is consequently architectural, and
Pavilion F has been so constructed as to afford means of
isolation and, at the same time, proper personal attendance.
Much of its best work has been accomplished in the treat¬
ment of acute cases of a very active character; and such
cases, when properly managed, afford the quickest and most
satisfactory recoveries, and have a legitimate claim upon
the general hospital.

The administration of Pavilion F is based upon that of
the other departments, except that the attending physician

APPENDIX III

3°*

has continuous service and is held to strict accountability
to the governors of the hospital. He visits at least once a
day, and exercises supervision and medical power. For a
few months after its opening the pavilion received patients
in the care of other physicians, but this was soon found to
threaten disturbance, discord, and even danger, from both
medical and legal points of view, and concentration of re¬
sponsibility was inevitable. The physicians of the com¬
munity have generally co-operated with the hospital, and
have assisted in the management of critical cases, realizing
the greater difficulties experienced before the creation of
this department, and the delicate questions involved.

The attending physician is assisted by two internes on
the medical service, whose duties are the taking of histories
and examination of the patients under his direction. The
greatest instrument for good, however, is the nursing care.

Some ninety nurses are under training in the hospital.
The course is of three years and includes every department.
In Pavilion F at least ten weeks are required, on day and
night duty on the men’s and women’s wards. The pupil
nurses are directed and supervised by the head nurse, who
is a woman of experience in mental work, co-operates with
the training school, is a part of it, and is an assistant to the
superintendent of nurses.

The standard of nursing is that established by the hospi¬
tal, and this in turn reflects the requirements of the most
exacting patronage of the community. The service given
by the nurses in the mental department has proved the
most substantial factor in establishing its high ideals. Nor
is the pavilion under an excess of obligation, as educational
elements are supplied which count largely in the equipment
of the nurse for the work in general medicine and surgery.
Clinical instruction is also given to the students of the

APPENDIX III

31*

Albany Medical College, who attend a weekly bedside
course during the college year.

At the end of five years this experiment in the therapeutics
of mental medicine is thought worthy of a report to the
National Conference of Charities and Correction. Facts
and experience have accumulated to justify a statement as
to whether an actual advance has been made in the most
difficult and least understood department of practice; or
whether, as is unfortunately too often the case in medicine,
as well as in dress, a fashion has been introduced to
indulge a passing fancy.

From February 18, 1902, the day of the first admission,
to February 28, 1907, one thousand and thirty-one patients
have entered this building. Of these five hundred and
ninety-six have returned to their homes recovered or im¬
proved, three hundred and sixteen have remained stationary,
and eighty-six have died. Two hundred and forty- five have
been transferred to institutions for the insane; of these one
hundred and twenty-six were sent to Pavilion F for deten¬
tion during the legal proceedings, and one hundred and
eighteen were committed after a period of observation. It
thus appears that nine hundred and five patients have been
under treatment without legal process, one hundred and
eighteen of whom it became necessary to commit later to
institutions for the insane.

If this special provision for the treatment of the mentally
deranged had not been made in the Albany Hospital, then
these nine hundred and five patients would either have
had to be improperly treated at home, or would have been
committed after a probably harmful development of the
disease. It is impossible to judge how many have been
saved from an unnecessary commitment.

A glance at the table shows that every form of mental

APPENDIX III

32*

alienation or defect has been represented. With reference
to personal mental responsibility patients may be divided
into three groups; first, those who know what they are
doing, and enter the hospital for treatment; second, those
who do not know what they are doing, and are brought to
the hospital; third, those who know what they are doing,
and decline to enter or remain in an institution.

In the first group are cases of neurasthenia, hysteria,
hypochondria, melancholia, mania, light grades of dementia,
some forms of drug addiction and alcoholism, and physical
diseases with incidental mental symptoms. These patients
are capable of making their wants known, of protecting
themselves against injustice or neglect, and of enforcing any
obligation of care or treatment assumed by the physician or
hospital.

The second group includes, primarily, cases of delirium
or stupor, and secondly, cases of feeble-mindedness, either
native, as in idiocy or imbecility, or acquired, as in advanced
dementia, the late stages of paresis, and old age. Delirium
and stupor are mental states due to acute and profound
changes in physical conditions, the pathological substratum
of which is exhaustion and toxemia. The cases are critical
and often fatal. They can rarely be treated at home, should
not be committed to an institution for the insane, and require
prompt and energetic measures, such as a general hospital
may give. The question of improper motive or unauthorized
interference is no more pertinent than when a patient uncon¬
scious from the uremia of bright s disease is plunged un
ceremoniously into a bath. T he mental enfceblement of
advanced dementia, paresis, and old age, gi\es opportunity
to designing persons, and care should be exercised by
the custodians of these helpless patients to protect them
from injustice. When property interests are involved it

APPENDIX III

33*

is wise that legal cognizance be taken of their incom¬
petency.

In the third group are cases of early paresis and of delu¬
sional insanity. The experience of Pavilion F has shown
that the confines of a small building are too limited for the
characteristic restlessness and magniloquence of paresis.
Delusional insanity is always a most troublesome condition.
Any form of opposition, detention, or restriction is resented,
and indeed the determination of the delusion may be diffi¬
cult, particularly when marital infidelity or domestic infelicity
is the basis of the disturbance. Husbands with quarrelsome
wives, wives with intemperate husbands, children with
degenerate parents, parents with disobedient children, occa¬
sionally look to the hospital for relief. Inasmuch as the
management of such patients involves the question of custody
rather than treatment, and restrictive measures are appro¬
priately decided by the courts, the hospital refrains from
engaging in these disputes.

It should not be forgotten that insanity is disease, and that
the determination by a court of the treatment of disease is
illogical. A few patients in incipient stages, less than
twenty-five per cent, and probably not more than ten per
cent, fail to recognize the morbid origin of their abnormal
thought and action, and decline the remedy. They become
a menace to themselves or others, and are subject to legal
measures because they are unsafe, violate law and order, and
render themselves liable to restraint. They constitute one
class for whom supervision is necessary. Another group of
patients are those who do not recover and need the good
offices of the court, not however for the safety of their neigh¬
bors, but because they are left, after the active disease has
subsided, with a mental scar, a defect in intelligence, and
are incompetent to carry on independently the duties of life,

APPENDIX III

34*

to mingle in society, or to support or protect themselves in
the struggle for existence. They are the demented, or ment¬
ally enfeebled, comprising the bulk of the State hospital
population, a rapidly increasing number who are a helpless
burden. It is right that provision for them be under the
jurisdiction of the State, in the interest of both the State and
its beneficiaries.

There is thus a clearly defined line between patients need¬
ing treatment and those subject to custodial care. For the
former the intervention of the court is unnecessary except in
rare cases, and then when an infraction has occurred or is
threatened; for the latter every technical requirement
should be observed. It is not intended to urge that the laws
should be ignored, or that an individual who resists treat¬
ment should be made forcibly to accept it, without opportu¬
nity for adjudication; but it is most imperative that patients
who are willing or anxious to receive medical treatment
should have it, and should have free access to institutions
conducted upon such a basis that they may voluntarily and
with confidence seek admission. The fault is not with the
statute, but with conditions which make harmful its
application.

In the enlistment of the general hospital in this sendee
certain requirements are to be observed. The institution
should be of high standing and command the respect of the
community. The department for mental diseases should be
established upon the standard of excellence prevailing
throughout. It should be somewhat removed from the
other wards that the distressing incidents of acute bodily
sickness, particularly the critical events of surgical service,
should not create or intensify apprehension and suspicion.
The wards differ in design from general hospital wards, and
should be more attractively equipped. Tastefully furnished

APPENDIX III

35*

sitting rooms, with books, games and magazines for diver¬
sion, may be provided. The custodial feature should be
reduced to a minimum, and intelligent visitation should be
encouraged that the patient may always have the assur¬
ance that an appeal to his friends may be made.

It is of first importance that the attitude of officers and
nurses should be one of sendee upon the patient, and never
one of dictation or assumption of superiority or command.
When the doors swing easily both ways there need be little
anxiety. Finally, in critical cases, there is no substitute for
the unremitting personal attendance of skilful and sympa¬
thetic nurses.

The function of a general hospital is the treatment of
acute disease. The question is now presented whether
there should be any limitation of this duty; that is, whether
certain forms of disease should be denied admission. For
large cities with numerous hospitals it may be expedient to
specialize, and to designate different acute diseases to dif¬
ferent hospitals. In smaller cities, of population varying
from fifty thousand to two hundred thousand, the two or
three good hospitals represent the purpose of the members
of the community to secure for themselves proper treatment
when sick or injured. The contribution of each individual,
whether through private or public channels, is his measure
of protection for himself or for some one near and dear.
If the calamity which sends him to this institution is mental
in character, he might demand, and he would be justified
in demanding, that he be not spurned, when his neighbor
with a surgical lesion or an infectious disease has at his dis¬
posal every means known to science for the restoration of
his health.

It is not to be expected that the work of a hospital for the
insane can be done in a general hospital. Nor can the

36*

APPENDIX III

work of a general hospital be done in a hospital for the in¬
sane. But there are many forms of mental disorder having
the character of an acute illness, and there are many forms
of actue physical disease with disturbance of mental function,
for which the general hospital should provide. Otherwise,
it is not a general hospital.

Table — Showing the Forms of Disease and the Results of
Treatment from the Opening of Pavilion F, February
18, 1902, to February 28, 1907

Form of Disease

Recov¬

ered

Im¬

proved

Unim¬

proved

Died

Remain¬

ing

Total

Total

M

w

M

w

M

w

M

W

M

w

M

w

Acute delirium .

20

20

7

7

I

s

7

7

I

I

36

40

76

Confusional insanity .

s

2

4

6

2

2

3

2

I

15

12

27

Melancholia .

17

17

18

49

20

44

2

I

57

114

171

Mania .

3

6

1 1

13

12

15

1

I

27

35

62

Primary dementia .

8

8

Chronic delusional insanitv •

1

3

16

18

I

17

22

39

16

8

Imbecility and Idiocy .

12

7

8

7

2

20

16

36

Acute alcoholic delirium . . .

109

8

15

5

2

13

2

139

15

154

Alcoholism .

19

5

60

3

6

2

4

89

10

99

Drug addiction .

5

3

5

4

3

1

2

11

12

23

8

6

17

8

3

1

1

8

8

2

Organic brain disease .

7

2

5

2

2

3

14

7

21

2

2

3

I

I

3

1

1

1

j

1

2

2

j

j

2

2

j

1

1

7

5

12

Totals .

185

69

197

145

160

156

S3

33

12

9

614

417

1031

APPENDIX IV

Verbatim quotation from the 14 th Annual Report ( October 1,
1901 — September 30, 1902) State Commission in

Lunacy of the State of New York , including a report on
abuses in private , run-jor-gain sanatoriums, written by
M. Allen Starr, M.D. — Professor of Nervous and
Mental Diseases at Columbia University.

The Private Licenses Retreat System

The number of private licensed institutions for the in¬
sane is now twenty-three. No new licenses have been
granted during the year. It is not desirable that the num¬
ber should be increased; on the contrary, a decrease would
be welcomed.

The Commission feels that there should be a more ade¬
quate system of visitation of these private retreats. An
inspection twice a year by the medical member of the Com¬
mission is not sufficient. While most of them are admirably
conducted, there are some which do not reach the standard
of the state hospitals in point of sanitary conditions and
means of care and treatment of patients. In some of them
patients are at times isolated for unconscionable periods
and restraint with muffs and camisoles is employed to an
unreasonable degree. In certain of them bathing facilities
are insufficient and protection from fire inadequate. In
some the proportion of attendants is too small, and even in
some of the best of them the quality of the nursing leaves
much to be desired. The following letter by Dr. M. Allen

37*

38*

APPENDIX IV

Starr to the “Medical Record” is presented as an evidence
of the low standard of nursing existing in some of the private
institutions:

Nursing in Private Insane Asylums

To the Editor of the Medical Record:

Sir: — The first steps towards the correction of any abuse
or evil are publicity of the facts and the awakening of public
interest; after this the pressure of public opinion is sufficient
to bring about a reform.

I desire to call the attention of the medical public, through
your columns, to an abuse which should surely be remedied.
I refer to the lack of proper nursing and care of patients in
private lunatic asylums in the vicinity. First as to the
facts:

Case I. — A lady of wealth and refinement, who became
insane in Germany, was brought home by her family, at¬
tended by skilled nurses, and, for a time, was kept in her
home. She was then sent to Asylum A, where she remained
for three years. During this time her nurses and companions
were women obtained from the Young Women’s Christian
Association of this city at a cost of twenty dollars per month
— decent persons, but wholly untrained in the care of
lunatics, and incapable of giving the mental direction and
help which a good trained nurse can give. Subsequently,
on her removal to her home and on being put in charge of
two skilful nurses, a marked improvement occurred up to
the time of her death, which took place from an intercurrent
disease. She was charged $100 a week at the asylum,
though the food was that of a ten-dollar boarding house.

Case II. — A young lady, who became acutely maniacal,
was sent to Asylum B for care. Her nurses were dismissed

APPENDIX IV

39*

and she was placed in charge of an Irish servant and a young
French woman, who had failed as a teacher and was willing
to take a place as nurse. Neither of them had experience,
and the days were passed in constant struggles between them
and the patient. For months this condition went on, though
the family were anxious to have extra nurses and were ready
to pay for them. They were charged seventy-five dollars
per week. The patient had to be fed on milk and eggs only.

Case III. — A lady suffering from chronic mania has
been ten years in one institution, Asylum C. She is happy
and able to be diverted. By accident I discovered that she
was regularly locked into her room by her companion at
8 p. m., the door into this companion’s room being thus
closed till 8 a. m., while she was often absent. Considerable
extra expense to the family was incurred, because the attend¬
ant had a large adjacent communicating room.

Case IV. — A lady suffering from melancholia had been
well cared for by two trained nurses and was improving,
when it was thought best to send her to Asylum D. On her
admission her nurses were discharged, as the physician “pre¬
ferred his own nurses.” Two weeks later I found her locked
in a room with a good-natured, ignorant Irish girl, who in¬
formed me that she had come to the asylum within a week
and had never done any nursing before. As proper com¬
panionship is essential to recovery in melancholia, I remon¬
strated with the physician, but no attention being paid to the
protest, I removed her, and at home, under proper care, she
recovered.

Case V. — A gentleman of means and high mental ability,
who had an attack of mild melancholia, was sent to Asylum E.
He has had a most faithful male nurse, intelligent, sober, and
capable of managing him perfectly. Three days after his
admission to the asylum this man was unexpectedly dis-

APPENDIX IV

40*

charged at night, and the patient was put in the care of a
rough, dirty Swede, who had been hired that very day, and
had never before acted as a nurse in an asylum. To my
protest the physician replied that he “could trust only his
own trained nurses — others were liable to drink and dis¬
obey orders.” Two weeks later my patient was found com¬
pletely terrorized by this man and complained bitterly of his
treatment and lack of companionship. He saw the doctor
for fifteen minutes daily, but was with the attendant all the
time. The man’s habits were filthy, and he was better fitted
for a stableman than for a nurse. The patient offered to
pay for the services of his former nurse, and to pay his
board in addition to the fifty dollars per week which he paid
for his single room. This proposition was declined. Hence
I removed him to another institution, where he is being
properly nursed, and is recovering rapidly.

Here are five cases in five different private asylums near
New York, all of which have a good reputation. In all the
same abuse exists — unintelligent care is the rule. In all
these places the doctor in charge sees the patient once a day
or every other day, as all have offices in New York. In all
the food is plain but wholesome, and served unattractively
and, usually, cold. In all prices from $50 to $100 a week
are charged. Double the charge would have been cheer¬
fully paid for skilful attendants in every case mentioned.

Secondly, as to the remedy:

It is well known that at Bloomingdale Asylum there is a
good training school for nurses, from which graduates come
out every year competent to take care of cases of mental
disease. If it became imperative upon these asylum physi¬
cians to employ trained nurses of good capacity, they could
be found and supplied. But since there is no demand made,
excepting by patients whose statements are not accepted,

APPENDIX IV

41*

or by relatives whose protests are disregarded, the present
evils continue. Many physicians wash their hands of a
patient as soon as he is consigned to an asylum, and if they
do visit him, it is soon made clear that such visits are re¬
garded as an interference by the doctor in charge. It seems
evident, therefore, that public opinion should be aroused
in this matter, and I hope this statement of facts of my per¬
sonal knowledge may awaken such a demand for the reform
of these abuses that good may come of this protest against
an existing condition.

Yours respectfully,

M. Allen Starr, M.D.